[sailgurlie]

I agree, the cleansing is the key... anytime a clinician skips that step, even if they think their ends or syringe are "clean" they put the patient at risk. Many nurses don't realize you should clean a port between accesses with a sterile syringe, but it is true. I would refer you to the manufacturer's directions for use of any product your facility is using. As far as "bad practice"- it is definately not easy to define as nursing has not been very good about backing up practice with evidence, but this is changing! Yeah! I am just hoping we can all work together to provide care based on "Best Practices"-

[iluvivt]

The INS cleary prohibits this practice. As an IV nurse for 22 years I have seen it all and I can tell you that a lot of nurses are not cleansing these injection ports. we are having a difficult time getting them to cleanse our positive pressure caps as well. Some nurses look at us annoyed when we (iv NURSES) insist that they cleanse injection ports and caps prior to medications and initiating infusions. The point is DO NOT LOOP. It is lazy sloppy practice and you need to ask yourself how would you like someone to care for your IV site?

[BBFRN]

I used to work in a facility that got 'dinged' several times during state inspections because of looping.

[canoehead]

I would be indifferent if my nurse looped. It's less infectious than accessing the cap and infusing- so who cares?

[ukstudent]

Originally Posted by iluvivt

The INS cleary prohibits this practice. As an IV nurse for 22 years I have seen it all and I can tell you that a lot of nurses are not cleansing these injection ports. we are having a difficult time getting them to cleanse our positive pressure caps as well. Some nurses look at us annoyed when we (iv NURSES) insist that they cleanse injection ports and caps prior to medications and initiating infusions. The point is DO NOT LOOP. It is lazy sloppy practice and you need to ask yourself how would you like someone to care for your IV site?

Why is it so bad? If you clean the port first, the pump is turned off/put on standby, what makes it so bad? The IV tubing that we use does not use clips, which means that when you disconnect you can either let it swing free in the air, place a needle (sharp) on it or loop it. Of the three, looping, with the use of alcohol swabs, is the safest for both the patient and myself.
So again, is it the lack of cleaning that makes it unsafe or is there something wrong and unsafe about looping even with cleaning?

[Jolie]

I'm probably going to sound really outdated here (which I am), but my question is why are IVs being disconnected so often? Granted I worked with neonates who are much easier to move around and clean up, and they don't get up to the bathroom, but why not just bring the IV pump and/or pole with the patient? It seems to me that the real infection control issue is repeatedly disconnecting and reconnecting the IV line.

[sailgurlie]

If you have read any of the current research on biofilm, you know it only takes one "bug" to get a whole mess growing inside the patient. Many well recognized IV therapy experts also recommend to NOT disconnect as often as we do. It has become commonplace and does increase the potential of infection. Just because we can do something doesn't mean we should... based on public reporting laws and third party payors starting to not reimburse for infections there will be greater focus than ever on our practice- thus it must be best practice, all the time. :smilecoffecup:

[cardiacRN2006]

Originally Posted by Jolie

I'm probably going to sound really outdated here (which I am), but my question is why are IVs being disconnected so often? Granted I worked with neonates who are much easier to move around and clean up, and they don't get up to the bathroom, but why not just bring the IV pump and/or pole with the patient? It seems to me that the real infection control issue is repeatedly disconnecting and reconnecting the IV line.

Sometimes people loop when the pt is getting up to go to the bathroom and the tech does it rather than go get the nurse. Sometimes it's done when the it's an IVPB and only get run every few hours.

I do it (and no, it's not sloppy or lazy) when I am dc'ing a certain gtt that I don't want left on. Like insulin or dopamine. Something I want off the pt but may put back on depending on pt progress.

To all the nurses who say it's 'lazy'...no one has ever addressed my points....

How is this any different then plugging in 2 or more compatable meds into the same line?

How is this port that the tubing is being looped into more or less dirty than the heplock?


Again--not lazy, not sloppy. It's fine, and not a safety issue at all.

[merellis2009]

At our hospital, we've been told that looping is an unacceptable practice and we could get written up for doing so. They've encouraged us to use a new sterile redcap on the end of the line any time we need to disconnect the patient (and have instructed us to try and disconnect as little as possible to avoid those bugs). Our nurse educator said that although theoretically, looping is still "sterile", anytime we connect/disconnect, it allows a new opportunity for bugs to come in, regardless of how well you clean the port. Not taking sides here, but just passing along what our facility does....

[LACrn]

Originally Posted by merellis2009

At our hospital, we've been told that looping is an unacceptable practice and we could get written up for doing so. They've encouraged us to use a new sterile redcap on the end of the line any time we need to disconnect the patient (and have instructed us to try and disconnect as little as possible to avoid those bugs). Our nurse educator said that although theoretically, looping is still "sterile", anytime we connect/disconnect, it allows a new opportunity for bugs to come in, regardless of how well you clean the port. Not taking sides here, but just passing along what our facility does....

This really is the only acceptable method to store tubing. The looping method IS "lazy" and 90% of the nurses who do it DO NOT wipe the port with alcohol before storing it in this manner. In our facility any tubing found stored in this manner is to be considered contminated and discarded. A new sterile cap is the appropriate way to store tubing for intermitent use!! I would venture to guess that if techs are d/cing infusions just for the patient to go to the bathroom, the ports are NOT being adequately "disinfected" prior to storing.