Prepare dressing materials. Perform hand hygiene and apply clean gloves. Apply mask. Instruct the patient to turn their head away from the site during dressing change or provide a mask for the patient. This reduces the transfer of microorganisms and prevents the spread of airborne microorganisms over the Central Vascular Access Device, or CVAD, insertion site.
Turn your head for me, please.
Remove the old dressing by stabilizing the catheter with your non-dominant hand. Remove the dressing by pulling up one corner and gently pulling straight out and parallel to the skin. Repeat on all sides until the dressing has been removed. Discard it in a biohazard container. In a home setting, you can use a trashcan to practice. Inspect the catheter insertion site and surrounding skin. You may verbalize that you are doing this so the grader is aware you are doing the step. Remove and discard clean gloves. Perform hand hygiene. Open CVAD dressing kit using sterile technique and apply sterile gloves. The area to be cleaned should be the same size as the dressing. Perform skin antisepsis with chlorhexidine gluconate (ChG) solution using friction in back and forth motion for 30 seconds and allow to dry completely. If using alcohol, perform a circular motion from inside toward the outside. Be sure to clean the tubing with chlorhexidine gluconate as well and allow to dry completely. Apply sterile TSM dressing over the insertion site. Remove gloves and perform hand hygiene. Apply a label to the dressing with the date, time, and your initials. Dispose of soiled supplies and used equipment.
