Registered Nurses' Association of Ontario

Add-On Devices

  • The intravenous (IV) system includes:
    • Parenteral fluids
    • Administration sets
    • Add-ons
    • In the case of PVAD, the peripheral short catheter.
  • When vascular access add-on devices are used, they are changed at least as frequently as with each catheter or administration set replacement, or whenever the integrity of either product is compromised.
  • Administration sets:
    • The administration set starts at the spike and terminates at the hub with a Luer-Lok™ connection to the vascular device.
    • All primary and secondary continuous IV administration sets should be replaced at a minimum every 72 hours or changed immediately if contamination is suspected or the integrity of the system has been compromised.
    • The IV administration set should be replaced whenever the vascular access device is re-sited.
    • Prior to changing any add-on component and before accessing the system, the nurse must disinfect external surfaces of the catheter hub and connection ports with an appropriate solution.
    • Change times according to solution type:

Solution Type

Set Change Frequency

Parenteral Nutrition (Amino Acids)

 

q 72 hours or when integrity compromised

 

Lipids, Parenteral Nutrition Solutions containing Lipids

 

q 24 hours or when integrity compromised

 

Whole blood & components (platelets, red blood cell

concentrate, plasma, cryoprecipitate)

 

4 hours or 2 units or immediately upon suspected

contamination

 

Fractionated products (IvIG, Clotting factors, Albumin)

Upon completion of infusion

 

  • Electronic infusion devices
    • The device should have anti-free flow protection and have a lock-out feature to prevent tampering.
    • Organizational policies should outline criteria for pump use, and should include routine preventive maintenance programs which adhere to manufacturer guidelines.
  • Peripheral short catheters site rotation
    • In order to prevent complications associated with prolonged dwell time much of the literature supports removing and rotating peripheral IV sites at least every 72 hours or immediately if contamination is suspected.
Clinical Management
Care and Maintenance to Reduce Vascular Access Complications
Point of Care Resources