Line management awareness program

HOLD THE LINE – 11 Steps to Superior Line Management and Safety

H – Hazard Identification and Prevention

  • Detect and correct tripping hazards, tangled cords, and unsecured tubing that may cause falls or contamination. Routinely inspect floors, bed rails, and walkways for risks.

O – Organized Line Routing and Securement

  • Ensure all lines are properly routed, labeled, and secured. Avoid crossing over walkways, under beds, or near wheels. Use line organizers to keep tubing elevated and visible.

L – Labeling and Legibility

  • Fully labeled lines with printed, clear identification at multiple points, including the tubing source, midpoint, and patient end. Labels should indicate the contents, date of connection, and tubing change date.

D – Daily Visual Safety Checks

  • Perform daily inspections of line placement and integrity, ensuring that there are no loose or frayed cords, tangled tubing, or unsecure connections. This includes tracing all lines from the patient back to the source.

T – Trace and Monitor During Handoffs

  • Full line tracing during handoffs, bedside rounding, and patient transfers. This prevents misconnections, supports emergency response, and allows for immediate correction of any identified issues.

H – Hand Hygiene and Infection Control

  • Prioritize hand hygiene before and after touching tubing or cords. Ensure critical lines are off the floor, and replace or sanitize any tubing or devices that fall. Use color-coded tags for easy identification.

E – Engage and Educate All Staff and Patients

  • Foster a team-based culture of line safety awareness. Educate nurses, CNAs, transport staff, and environmental services on proper cord and tubing management. Engage patients and families in understanding what is safe to touch and when to call for assistance.

L – Line Reconciliation and Emergency Readiness

  • Line reconciliation ensures all lines are accounted for and properly connected. This step involves checking the traceability and placement of every line during emergency preparedness and routine assessments.

I – Implement Safe Reporting Systems

  • Create a non-punitive environment where staff can report line hazards or unsafe practices anonymously. Encourage proactive identification of risks before harm occurs.

N – No Workarounds – Standardize Practices

  • Eliminate makeshift solutions like taping lines or using random objects to hold tubing. Adopt standardized tools like Beata Clasp organizers, breakaway connectors, and color-coded tags to replace inconsistent and unsafe methods.

E – Environmental Scanning and Routine Rounds

  • Conduct environmental scans and routine rounds to identify hidden risks, prevent tangling, and maintain clear pathways. Ensure line management practices are followed across all patient care areas.

 

11-Step Implementation Plan for HOLD THE LINE

  1. Identify Hazards – Inspect floors, beds, and pathways for tangled cords, frayed wires, and tripping risks.

  2. Organize Lines Properly – Route all tubing and cords securely, using line organizers and fasteners to avoid clutter.

  3. Label All Lines Clearly – Apply printed labels at multiple points with legible information, including contents and change dates.

  4. Perform Daily Safety Checks – Visually inspect all lines during every shift for damage, disconnection, or improper routing.

  5. Trace Lines During Handoffs – Conduct full line tracing and reconciliation during every patient transfer or handoff.

  6. Prioritize Hand Hygiene – Enforce hand sanitation before and after touching tubing, especially after floor contact.

  7. Educate and Engage All Staff – Provide training for nurses, aides, transport, and environmental services on line safety protocols.

  8. Ensure Line Reconciliation – Account for every line during rounds and emergency drills, making sure connections are correct.

  9. Support Safe Reporting – Encourage anonymous reporting of hazards without fear of retribution, creating a culture of trust.

  10. Eliminate Workarounds – Replace makeshift solutions with approved tools to standardize safety practices.

  11. Conduct Environmental Rounds – Perform routine checks to identify hidden hazards, prevent clutter, and ensure lines are clear of walkways.