[hikernurse]

Thanks, Eliza .

[NicuGal]

We leave HAL tubing and med tubing up for 72 hours. We leave our med tubing with the flush on it, we just wipe the connection part before changing the syringes. We also use the trifurcated tubing with the filter, it is awesome!

[babiesRmylife]

In our unit after the med is given we throw it all away. We don't reuse tubing what-so-ever.

[preemieRNkate]

Originally Posted by babiesRmylife

In our unit after the med is given we throw it all away. We don't reuse tubing what-so-ever.

Ditto. And all IV solutions and tubing, regardless of what they are, get changed q24.

[elizabells]

Originally Posted by preemieRNkate

Ditto. And all IV solutions and tubing, regardless of what they are, get changed q24.

How are your CLASBI rates? I know our protocol was a specific attempt to lower ours, which were really high. I guess the theory is that opening the line up over and over to detach/attach new med tubing was a bigger risk than re-using the med tubing.

[iyqyqr]

I have been surprised to see the high CLASBI rates in many of the NICU's I have traveled to AND the elaborate methods tried in an effort to decrease the rates. My home unit line infection rates have always been very low and to date we have gone 244 days without a line infection! All of our tubing and y'd in drips are assembled in pharmacy under a laminar flow hood and they and solutions are changed every 24 hours. When the fluids arrive on the floor we simply prime and hook them up to the pt. We don't gown or glove, we have no med bags, just an extension tubing for meds which is capped and the meds are given and then we flush with 3ml syringes of NS, which are to be tossed after each use. We have an excellent nurse in charge of our lines and protocols and she feels it is many little details that combine to provide a low infection rate. I'm presently working in a unit where the only meds that can be given in central lines are aby and only if the line had a positive culture. All other IV meds are given in PIV's and I feel like I have returned to nursing in the 80's. The babies look like pincushions!!

Originally Posted by elizabells

How are your CLASBI rates? I know our protocol was a specific attempt to lower ours, which were really high. I guess the theory is that opening the line up over and over to detach/attach new med tubing was a bigger risk than re-using the med tubing.

[Gompers]

We must be the only ones that never re-use med tubing. They do it in the PICU but we don't in the NICU here. We use fresh tubing every single time and disconnect it after the med is done infusing.

Our IV tubing for fluids and drips is changed every 96 hours, except for lipids which gets a new bag and new tubing every 24 hours. If it's something factory-made, like heparinized saline or plain D10W, we can leave the same bag and tubing running for 96 hours. If it's made by the pharmacy, like hyperal or drips, a new bag is spiked or a new syringe is hung each day, but using the same tubing for 96 hours.

[elizabells]

Originally Posted by iyqyqr

I'm presently working in a unit where the only meds that can be given in central lines are aby and only if the line had a positive culture. All other IV meds are given in PIV's and I feel like I have returned to nursing in the 80's. The babies look like pincushions!!

Pardon my language, but that is the dumbest damn thing I've ever heard. What do they do with dopamine? K runs? Have these people never seen what extravasated epi will do to a limb? I'd last about ten minutes on that unit. I salute you for being a better person than I.

[iyqyqr]

Originally Posted by elizabells

Pardon my language, but that is the dumbest damn thing I've ever heard. What do they do with dopamine? K runs? Have these people never seen what extravasated epi will do to a limb? I'd last about ten minutes on that unit. I salute you for being a better person than I.

Dopamine would be a drip and is y'd in with the Hal and Lipids , K would be given PIV and watched very carefully. All IV push meds and aby are given PIV except when the line is infected. This has been very hard for me to accept, esp since this is one of the top NICU's in the nation. They also gown, hat, and mask to prime or if they enter the CL, BUT use clean gloves and put all supplies on a CLEAN chux. Their infection rates were high, and I have some ideas why. After much discussion this is the protocol they arrived at and I feel the pt has paid the price. I haven't flushed so many PIV's since the early years of my 26 year NICU career. And this with a Broviac or PICC in place. Most babies have two and the sickest ones three PIV's. And with adult, not neo trifuses; oh, and all PIV's are on arm and footboards. Can you imagine trying to nest one of these pts? I have also been surprised that many units use the adult, red, white and blue trifuses. Do they not know that there are sweet neo brands, so our tiny ones aren't weighted down?

[NICU32RN]

That would make me insane.