Anyone NOT use prefilled flushes?

[Mommy TeleRN]

I have experience at 2 hospitals as a student. One uses prefilled flushes (as I imagine most hospitals do) One does not. Supposedly it is cost saving. You have to open the syringe, wipe the tip of the saline bag with alcohol, fill the syringe, and cap it (they have the little caps in a package) and if you are prudent, slap a NS label on it. Just seems so odd to me to share a saline bag to fill flushes. Is this standard practice anywhere else?

[TazziRN, RN]

Tazzi - I guess if I had to choose I would prefer a bag too.. it's a pain to attach a needle to fill - one more step.

No, what I meant was, if I had to use a bag and had no other choice, I would use a 50ml bag for each pt, rather than a 500-1000ml bag for multiple pts.

[Gromit]

We use the prefilled syringes (10ml) as well -and when we run out of them, the small 30ml bottles (I always keep one in my pocket, along with the prefilled syringes -just in case -I always need just one more when I'm in an isolation room -so I just put a bottle in the room). Yes, the bag COULD cross-contaminate.

[lorster]

I work at two different facilities right now. One uses prefills and one uses the NS vials for multiple use. According to the hospital, they cost the patient about 10.00 a piece so they are on us to not waste them. I think they are the only way to go as even though we date the vials at the other facility, I have no proof as to how the last nurse used the vial such as, did she/he pull from the NS vial first? Are there other meds mixed in there after multiple uses? I don't know. I feel it is safer going with the prefills myself. Plus so much more convenient, grab and go.

[Gromit]

Our facility is rather large, so they do a lot of those 'cost' studies (makes sense -818 acute care beds, and 59 rehab, and they are building more of the former). Some time back, they decided that the prefilled flush syringes were actually a cost-saver (I only assume this is due to lessening the chances of accidental needle-sticks, fewer parts being assembled to fill and use said syringe (get a needle, a bottle or other source for saline, draw it up, put a needle-less device on it, use it. ) but not sure exactly how they came up with the results. I only know that its far more convenient for US to use :)

[NurseCherlove]

Our facility is rather large, so they do a lot of those 'cost' studies (makes sense -818 acute care beds, and 59 rehab, and they are building more of the former). Some time back, they decided that the prefilled flush syringes were actually a cost-saver

Man, I wish I could get my hands on the literature supporting that so I could give it to my manager!!!! We have to use those 30 mL vials to draw up our own flushes - SOOOO time consuming!!!!!!

[firstyearstudent]

I am doing a preceptorship at a facility that uses prefilled syringes, but they are all 3 ml. All the nurses use them to flush PICC lines, not just IVs, which we were told in school not to use with PICCs because the pressure is too high and will damage the lumen and possibly injure the patient.

[CritterLover, BSN, RN]

i am doing a preceptorship at a facility that uses prefilled syringes, but they are all 3 ml. all the nurses use them to flush picc lines, not just ivs, which we were told in school not to use with piccs because the pressure is too high and will damage the lumen and possibly injure the patient.

most of the 3cc flush syringes are actually 3cc of saline in a 5 or 10cc sryinge.

even if it truely is a 3cc syringe, as long as the syringe barrel is as large as a 5cc syringe, it is ok.

it is the size of the barrel of the syringe (the diameter) that determins the amount of pressure the syringe creates. so, this might be ok.

edited to add:

it is still kind of silly to use the 3cc, since most piccs need to be flushed with 10 cc of saline, so that means using 3-4 of the 3cc flush syringes. but sometimes (esp with patients that have volume-overload issues) i would use a 3cc flush between meds, and then use 10cc saline at the end.

[firstyearstudent]

It is definitely a very skinny 3 ml syringe.

[DutchgirlRN, ASN, RN]

I would never use a bag of NS that had already been accessed by someone else.

:yeahthat: I totally agree! We used to have 10ml bottles of NS that we used to make our own flushes. We didn't charge for them. It seemed like a pain at the time. For the past couple of years we have used pre-packaged NS. We charge for them which means we have to get them out of the pyxis and have to scan them before flushing. I would love to go back to the individual bottles but I imagine they are making $$$ in the pre-packaged flushes.

[Marie_LPN, RN, LPN, RN]

We have prefilled flushes of saline and prefilled flushes for heparin.

Which WOULD be a great thing except for this.

The saline flushes, and heparin flushes have the same colors, markings, wrapper. The only difference is the writing on the side that is 1.5 mm tall (i measured it).

Which we all (should) know to triple-check anything, but the visual similarity is such a bad idea.

[firstyearstudent]

More bad design...

http://www.baddesigns.com/insulin.html

[Marie_LPN, RN, LPN, RN]

I liked the phrase "Annoying side effects" LOL

http://www.baddesigns.com/wachout.html