Procedure:

1. Wash hands thoroughly.

2. Clean the surface of your work area with alcohol.
3. Gather necessary equipment.
4. Prepare supplies for use and place on the cleansed work area.

5. Remove old dressing carefully to avoid any pulls or traction on the catheter, do not use scissors. Use tape remover to remove tape if needed.

6. Observe the exit site for evidence of infection: redness, swelling, drainage.
7. Discard old dressing.
8. Wash hands.

9. Using sterile Q-tip dipped in hydrogen peroxide, cleanse exit site to remove any drainage. Dry exit site with dry Q-tip.

10. Using a Povidone iodine swabstick, cleanse the exit site and surrounding skin. Start at the exit site and circle outward to cleanse the skin. Repeat this cleansing using all three swabsticks.

11. Pour hydrogen peroxide on two 4 x 4's. Pick up by four corners, clean site again starting at exit site and cleaning outward. Repeat with second 4 x 4.
12. Pick up dry 4 x 4 by pinching it and lay on exit site. Pat skin dry.
13. Cleanse the catheter with Povidone iodine swabaid by wiping from the exit site to the end of the catheter. Avoid tension on the catheter by using a "pinching" action to move swabaid to end of catheter.
14. Apply skin protective agent to the skin if necessary. Avoid areas of skin breakdown.
15. Coil tubing over the exit site using sterile Q-tip. Allow clamp and end of catheter to extend out from under dressing.
16. Cover with tegaderm.