[carriedf]

I'm looking for some thoughts on a question I brought up on a similar forum. I'm currently working at a hospital (i have only been here 4 months) where they are re-writing a policy for pitocin infusion primarily for cost effective measures, obviiously not patient safety! The way that I have always admin pitocin (6 yrs at another hospital in LDRP) was having a mainline of LR to the patient (via pump or free flow), then putting pitocin on its OWN line and pump(or double pump) and attaching that line to the closest port on the primary line closest to the patient. Now i am seeing nurses running a main line of LR into a pump but then instead of putting pit on its own line they are putting the pit on a "secondary set" and piggying into the LR above the pump and using the secondary (or B side) of the pump to control it. This started happening when DPH was around and they were requiring the LR to be on a pump(good idea!) but we did not have enough pumps so some nurses started doing this. Now because of this the new policy is going to be pitocin on a secondary set! Sooo my question to you all is...what is your thoughts and practice on this (am I just over worrying!) and do you know of any articles or links to acog or awhonn that would support my argument of the safety issues in piggybacking pitocin to a mainline ABOVE the pump. oh and fyi the old policy at this hospital stated that the pit should always be run on its own line through the pump and piggyed into the distal port of the primary line. Funny how money trumps safety!!

[moongirl]

our pit is ALWAYS ALWAYS run on its own pump, own line, ported into closest to pt.

[Jolie]

See the following thread for a recent conversation on this subject:

http://allnurses.com/forums/f35/pito...mp-300103.html

[carriedf]

I have not spoken with her yet but i believe the person who wrote that original thread is the nurse on our unit who is re-writing the policy!!! What are the chances!! But at least I'm glad she is getting the input from other nurses. I hope she takes the advise and information that everyone has given and makes an informed decision. This is why I think it is so important to have support from awhonn or acog!!!

[carriedf]

This is what my practice is and now I feel that I am being told that I have to do it a different way and this way is not safe!! Any advise??

[l&drocks]

Pit is always supposed to be on its own pump and piggybacked at the lowest port of a mainline. This sounds like a lawsuit waiting to happen with 2 different fluids on the same pump. If it is set a secondary rate what if the primary kicks back in??

[NurseNora]

Measure how many ccs are in the line from the top port to the end. Figure how many mUs of pit would be in that line. We use a concentration of 30U in 500cc, that works out to 60mU/cc. If there is 1cc (and I suspect that it is more) of fluid in the tubing between the top port and the patient, even after I turned the Pit off and started a plain LR bolus for distress &/or hyperstimulation I would administer an immediate dose of 60mU of Pit. If I had a patient who hyperstimed at 8mU/min, she would be in really bad shape with a bolus of 60 mU. That's why it's important to plug the pit into the lowest port: so that when you turn off the pit, you really stop administering it.

Point out to the powers that be that the savings on tubing and pumps will be greatly offset by the lawsuits that may result. It's poor practice. Check AWHONN's guidelines; I'm sure they specify using the lowest port.

[jhhrn68]

I am a little confused by this question. Is this Pitocin being given for induction or augmentation or are you taking about post-delivery? For induction, you would absolutely need separate pump, but post delivery, I can't see that it makes much difference. After all, how many women deliver babies and never get synthetic oxytocin but just rely on Mother Nature? We run our post delivery Pit at a bolus rate and d/c the IV when it is done.

[carriedf]

yes, just for induction or augmentation, we run our pit open after delivery. thank you, i have always been told only to run pit on its own pump!