Page 63 - policy and procedure infection control

Policies and Procedures on Infection Control

 If triple lumen catheter or a pulmonary arterial catheter infusion port is used for
PN administration, a single lumen must be dedicated for PN only. This should be
labeled and dated and must not be used for other purposes. There should not be
any entries to the PN line except for lipid infusions or in emergency situations.
2. Procedure for insertion of catheter (refer to intravascular line)

3. Surveillance of the PN line
 PN solutions hung, but not infused shall be discarded after 24 hour and ready to
use (commercial preparation) bag after 48 hour
 Evaluate the patient at least 8 hours or every shift for evidence of cannula-related
complications
 Visually inspect the catheter site if the patient has developed pain or tenderness
at the insertion site, fever without obvious source, or symptoms of local
bloodstream infection
 Observe signs of infections: redness, inflammation or purulent drainage from
insertion site
 Do not routinely perform surveillance cultures of PN devices used during
intravascular access
4. A dedicated lumen used for PN line should be identified and not be used for
other purposes
The following are contraindicated when using a central venous lumen for PN:

 Transfusions of blood or blood products
 Drawing of blood samples
 Bolus injection of drugs
 Simultaneous administration of IV solution
 Measurement of CVP
 Aspiration of blood for routine lab tests

 Addition of medication to TPN
5. Replacement of PN tubing and filters
 Preparation PN 2 in 1
a. If filter 0.2 micron 24 hour is used, change filter, tubing and bag after 24 hours.
b. If filter 0.2 micron 96 hour is used, only change the tubing and bag after 24
hours and discard filter after 96 hour.

c. Change administrative set for lipid with or without filter 1.2 micron filter for 24 hours.
 Preparation PN 3 in 1 shall be infused with a 1.2 micron filter. The tubing, filter
and bag should be changed every 24 hours.
 Change the tubing and filter if the system slows. Flushing or irrigation of the
system should be avoided.

52 Ministry of Health Malaysia