Definition
You remove the soiled gown and replace it with a clean one while keeping the IV line secure and the fluid running without interruption.
Equipment
- Clean hospital gown
- Disposable gloves
- Top sheet or blanket
- Container for the soiled gown
- Hand sanitizer or soap and water
Procedure
- Prepare the new gown (a unisex, one-size A-line gown) and keep it within reach, so there is no delay mid-change.
- Explain the procedure and reassure the patient the IV line stays secure. This builds trust and cooperation.
- Check the IV site and tubing are secure, with no dislodgement or leakage, before you start.
- Untie the gown at the neck and back to free it without moving the IV line.
- Remove the gown from the non-IV arm first, off the shoulder and arm. Doing the unaffected side first avoids pulling on the line.
- Slide the other sleeve off the shoulder, over the arm, IV catheter, and tubing. Detach the fluid container from the stand and slide the gown over it, keeping the container above the infusion site at all times. This prevents dislodgement or kinking that would disrupt fluid or medication delivery.
- Remove the gown under the top sheet and dispose of it in the container, which keeps stress off the IV line.
- Recheck the IV line and tubing are intact and well positioned; adjust if needed.
- Gown the IV arm first: put the sleeve over the fluid container, rehang the container, then slide the gown over the tubing and the arm with the catheter, and position it on the shoulder. Starting with the IV arm manages the tubing and reduces pull on the line.
- Put the clean gown over the other arm and shoulder.
- Tie or fasten the gown at the neck and back for coverage and comfort.
- Verify the IV line is not kinked or pulled and is functioning correctly.
- Make sure the patient is comfortable and the gown is not causing pressure.
- Document the gown change and any observations in the chart.
Perform hand hygiene and put on gloves before you start, and clean your hands again after the change and after any contact with the IV site, in line with CDC guidance for healthcare workers (CDC).
Frequently Asked Questions
Why change the gown over the IV arm last when removing and first when reapplying? Working the non-IV arm first on removal and the IV arm first on application keeps tension off the catheter and tubing, which lowers the chance of dislodging the line or interrupting the infusion.
What do I do with the fluid bag during the change? Detach the bag from the pole and pass it through the sleeve while keeping it above the infusion site the entire time. Holding the container above the site prevents backflow and keeps fluid or medication flowing without interruption.
Do I need to stop the infusion to change the gown? No. The procedure is designed so the line stays connected and running. If you cannot keep the bag above the site or the tubing is at risk, pause and reposition rather than disconnecting, since opening the system raises the risk of bloodstream infection.
What hand hygiene is required? Clean your hands and don gloves before the change, and perform hand hygiene again afterward and after any contact with the IV site or tubing. Hand hygiene before and after patient contact is the single most effective step for preventing healthcare-associated infections (CDC; CDC).
What should I check after the change? Confirm the IV site is intact with no leaking, swelling, or redness, that the tubing is not kinked or pulled, that the infusion is running at the correct rate, and that the patient is comfortable. Document the change and any findings.