Can Nurses Change Central Line Dressing? Your Scope of Practice Explained

September 28, 2025 •

4 min read

According to the National Institutes of Health, proper central line care is essential for preventing dangerous infections. A key component of this care is the dressing change, and the answer to can nurses change central line dressing? is a definitive yes, provided they have the correct training and demonstrated competency.

Quick Summary

Nurses with demonstrated competency and adhering to strict aseptic technique are authorized to perform central line dressing changes. This critical skill is governed by institutional policy, professional standards from bodies like the Infusion Nurses Society (INS), and individual state nursing board regulations, ensuring patient safety and reducing infection risks.

Key Points

Competency is Key: Nurses must be specifically trained and assessed for competency before performing a central line dressing change.
Aseptic Technique is Non-Negotiable: Strict sterile procedures are required to prevent serious central line-associated bloodstream infections (CLABSIs).
Frequency Depends on Dressing Type: Transparent dressings are typically changed weekly, while gauze dressings must be changed at least every two days.
Scope of Practice Varies: State regulations and facility policies dictate which types of nurses (RN vs. LPN) are authorized to perform this procedure.
Daily Assessment is Crucial: Nurses must assess the insertion site daily for signs of infection, regardless of the dressing change schedule.
Proper Documentation is Required: Thoroughly documenting the procedure, assessment findings, and patient's response is a critical nursing responsibility.

Understanding the Nurse's Role in Central Line Dressing Changes

Within a clinical setting, nurses are on the front lines of patient care, and maintaining central venous access devices (CVADs) is a standard part of their duties. Changing the central line dressing is a critical task that falls squarely within a nurse’s scope of practice, provided they have been properly trained and their competency is verified. This procedure is not just a routine task; it is a vital infection control measure aimed at preventing Central Line-Associated Bloodstream Infections (CLABSI), which are a significant and serious risk for patients.

The Importance of Aseptic Technique

For a central line dressing change, aseptic technique is not optional—it is mandatory. The procedure must be performed in a sterile manner to prevent microorganisms from entering the bloodstream through the catheter insertion site. Failure to follow a strict sterile procedure can introduce pathogens, leading to severe and potentially life-threatening infections. This is why nurses receive extensive training on the proper use of sterile gloves, masks, and cleaning agents like chlorhexidine during the procedure. Even small details, such as ensuring the patient turns their head away from the site, are important parts of the aseptic process.

Key Steps in the Central Line Dressing Change Procedure

Preparation and Assessment

Gather Supplies: A sterile dressing change kit, sterile and non-sterile gloves, a mask for both the patient and the nurse, and a bio-occlusive dressing.
Patient Education and Positioning: Explain the procedure to the patient and have them turn their head away from the insertion site to minimize contamination. The nurse and anyone assisting must also wear a mask.
Site Assessment: Don clean gloves to carefully remove the old dressing. Inspect the site for any signs of infection, such as redness, swelling, or drainage. Note the external length of the catheter to check for any migration.

Sterile Procedure

Hand Hygiene: After removing the old dressing, remove the clean gloves and perform meticulous hand hygiene.
Create Sterile Field: Open the sterile kit and don sterile gloves.
Clean the Site: Use the antiseptic swab (typically 2% chlorhexidine gluconate in 70% isopropyl alcohol) to clean the insertion site. Scrub with a back-and-forth motion for at least 30 seconds and allow the site to air dry completely.
Apply New Dressing: Apply any antimicrobial patches or securement devices as per protocol, then place the new transparent dressing over the site. Smooth it from the center outwards to ensure a complete seal.

Completion and Documentation

Secure and Label: Label the new dressing with the date, time, and your initials.
Document: Record the procedure, assessment findings, and patient tolerance in the medical record.

Gauze vs. Transparent Dressings for Central Lines

Different types of dressings have varying protocols for how often they must be changed. This table outlines the key differences and uses.


Feature	Transparent Semi-Permeable Dressings (TSM)	Gauze Dressings
Appearance	Clear, allowing for visual inspection of the site.	Opaque, requires removal for site inspection.
Frequency of Change	Typically changed at least every 7 days, unless soiled or lifted.	Must be changed at least every 2 days.
Patient Comfort	Thin and flexible, less bulky.	Thicker and more absorbent, can be more restrictive.
Infection Prevention	Effective when used correctly with aseptic technique.	Effective, but more frequent changes required.
Best Used For	Most central lines, allows for easy monitoring of the site.	Sites that are actively bleeding or leaking; can be used with transparent dressing over top.

Scope of Practice: RN vs. LPN and Facility Policies

The ability of a nurse to perform a central line dressing change is also determined by their licensure and specific facility policies.

Registered Nurses (RNs): RNs are fully within their scope of practice to perform central line dressing changes once their competency is validated. They also assess the patient, manage complications, and educate patients and families.
Licensed Practical Nurses (LPNs): The scope of practice for LPNs is more limited and varies by state and facility. Some states allow properly trained LPNs to perform dressing changes on certain types of central lines, while others do not. It is crucial for LPNs to know and adhere to their specific state and facility regulations.
Facility-Specific Competency: All nurses, regardless of licensure, must complete specific training and be signed off as competent by their facility to perform this procedure. This ensures they follow the latest evidence-based practices and institutional policies.

Conclusion: Trained Nurses are the Standard

To summarize, the responsibility for changing a central line dressing safely and aseptically lies with a properly trained and competent nurse. This is a crucial skill that directly impacts patient outcomes and minimizes the risk of infection. Understanding the protocol, adhering to professional standards from bodies like the Infusion Nurses Society, and following facility policy are all paramount to providing safe, high-quality care.

For more information on the latest best practices, refer to the Infusion Nurses Society (INS) Standards of Practice.

Frequently Asked Questions

The frequency depends on the dressing type. Transparent, semi-permeable dressings should be changed at least every seven days, while gauze dressings should be changed at least every two days. Any dressing that is wet, soiled, or loose must be changed immediately.

If a central line dressing gets wet, it loses its sterile barrier and must be changed immediately. A wet dressing creates a pathway for germs to enter the insertion site and cause infection.

Typically, a nursing student can only participate in a central line dressing change under the direct supervision of a qualified and competent Registered Nurse or clinical instructor. They must adhere to strict aseptic technique and facility policy.

During a central line dressing change and daily assessments, a nurse should inspect the site for redness, swelling, warmth, tenderness, pain, or any drainage (pus) from the insertion site. These are all potential signs of infection.

Yes, specialized dressings are used for central lines. These often include chlorhexidine-impregnated gel pads or other antimicrobial dressings to provide an extra layer of infection protection at the insertion site.

CLABSI stands for Central Line-Associated Bloodstream Infection. This is a serious infection that can occur when germs enter the bloodstream through the central line. Strict adherence to aseptic technique during dressing changes is a key strategy to prevent CLABSIs.

Yes. While it is within a nurse's scope of practice, it is considered a specialized procedure. Nurses must receive specific training, demonstrate proficiency, and follow institutional protocols to ensure competence and patient safety.