Discharge Instructions: Changing the Dressing on Your Central Venous Catheter

You are going home with a central venous catheter in place. A central venous catheter is a small, soft tube that is placed in a vein in your neck or chest. This is usually a temporary tube that takes the place of an IV (intravenous) line. It is often used when medications or nutrition need to be given over a period of weeks or months. Having a central venous catheter means that you will not have to have an IV replaced every few days.

You will need to care for your catheter to keep it clean and working. Care will include changing the dressing, flushing the catheter with fluids, and changing the cap on the end of the catheter. A nurse or other healthcare provider will work with you and your family to teach you everything you need to do. This sheet covers the steps for changing your dressing.

Home Care

• Change the dressing over the site as directed by your doctor. You, a family member, or a nurse may perform the dressing change. Some doctors prefer that patients visit the office for dressing changes.

• Learn sterile dressing technique if you plan to change the dressing yourself. Ask your doctor or nurse how to perform sterile dressing changes.

Clean Your Work Area

• Put pets and children out of the room.

• If the surface is washable, clean it with soap and water, and dry it with a clean cloth or paper towel.

• If you are working on a surface that is not washable, such as wood, wipe it free of dust. Spread a clean cloth or paper towel over the surface.

• Move away from the clean surface, if you need to cough or sneeze.

Wash Your Hands

Always wash your hands before and after any contact with any part of your central venous catheter.

• Turn on the water.

• Wet your hands and wrists.

• Use liquid soap from a pump dispenser. Work up a lather.

• Scrub your hands thoroughly.

• Rinse your hands with your fingers pointing toward the drain.

• Dry your hands with a clean cloth or paper towel. Use this towel to turn off the faucet.

• Remember, once you have washed your hands, don't touch anything other than your supplies. You must wash your hands again if you touch anything else, such as furniture or your clothes. 

Gather Your Supplies

Supplies are often available in “kits” called change trays. These trays contain the supplies you need, organized in a way that makes them easier to use. You were shown how to use a kit in the hospital. Here are the supplies that are contained in the kit:

• Antiseptic swab sticks

• 1 pair of scissors

• Tape

• Sterile gloves

• Transparent adhesive dressing

• Steri-Strips

Remove the Old Dressing

• Place the sterile dressing change tray on your clean work surface.

• Take the plastic covering off the sterile tray. Stop. Remove the covering only. Don’t open the tray. (Keep the plastic covering to dispose of the old dressing later.)

• Take the old dressing off by gently pulling up the edges of the transparent dressing. Start at the side closest to your hand. Carefully peel the dressing off while holding the catheter at the site so that it does not get pulled out.

• Wrap the old dressing in the plastic covering that you removed from the sterile tray. Discard the dressing and plastic covering.

Prepare the Sterile Field

• Open the sterile tray by unfolding the paper wrapper on the sterile tray. Start with the fold that is farthest away from you. The surface of the paper wrapper is called the sterile field. Be sure nothing (other than the contents in the tray package) comes in contact with the sterile field.

• Open the Steri-Strip and transparent dressing packages. You may touch the outside of these packages, but not the contents. Let the contents of the package drop onto the sterile field. Throw the packages away. Don’t let the packages touch the sterile field.

• Put on sterile gloves. You were shown how to put on sterile gloves before you left the hospital. Ask for an information sheet to help you remember how to put on the gloves.

Clean the Area and Apply the New Dressing

• Clean around the area where the catheter comes out from your skin with 3 of the antiseptic swab sticks.

  • Start at the center and work outward, but don’t go back toward the center.

  • Make sure to clean the entire skin area that is covered by the dressing.

  • Discard the swab sticks.

• Allow the area to dry.

• Clean around the exit site with the 3 more antiseptic swab sticks. Allow the area to dry for 2 minutes. Discard the swab sticks.

• Tape the wings of the catheter (if present) to your skinwith the Steri-Strips.

• Apply the transparent dressing. Put the top end down first and smooth out the rest across the area where the catheter comes out from your skin.

• Make sure the transparent dressing covers the entire catheter, including the end piece.

• Take off and discard the sterile gloves.

• Tape the injection cap (end of the catheter) to your arm.

Follow-Up

Make a follow-up appointment as directed by our staff.