Table 5. Antimicrobial Lock Implementation
Instilling an Antimicrobial Lock
1. To avoid errors, order the antimicrobial lock therapy through the electronic medical
record system, if used in the facility.
2. Obtain pharmacy-dispensed volume-specific syringes for each lumen.
3. Prepare for:
a. 4 hours of dwell time (optimal).
b. Changing all line locks solutions inserted into ports every 24 hours.
4. Flush each lumen with 0.9% sodium chloride before instilling the antimicrobial lock.
5. At the end of the dwell time, withdraw the instilled antimicrobial lock priming volume
and discard. Some institutions will withdraw an additional 0.1 mL, or an additional
percentage of the total volume.
6. After removing and discarding the lock, flush the lumen(s) with 0.9% sodium chloride
before infusion of other medications or fluids through the line.
7. If patient is being transferred to a procedure area (line may be accessed), withdraw all lock
solutions prior to patient's leaving the unit.
8. Obtain VAT evaluation and intervention if unable to withdraw antimicrobial lock from
any lumen.
Assessing Fill or Priming Volume of Existing CVCs
1. Perform hand hygiene.
2. Disinfect cap/lumen connection with hospital-approved antiseptic.
3. Clamp the lumen and remove existing needleless access device from the CVC hub of the
lumen.
4. Attach empty 3 mL luer-lock syringe directly to the hub of the lumen.
5. Aspirate plunger slowly and gently until blood reaches the end of the hub.
6. Clamp the line.
7. Remove the syringe: the volume of fluid in the 3 mL syringe is the volume to be used for
the lock volume.
8. Flush the line.
