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?

[Roy Fokker, BSN, RN]

The first thing I do when I walk out of the report room is stuff me left pants cargo pocket with 5-7 flushes and 3-4 cannula-tip caps.

AM or PM shift is usually so busy that flushing heplocks isn't a priority. So I always flush my patients locks when I do my assessments. Saves us the trouble of having to stick them again because of an occluded site

Besides, they are a convenient source for diluting Toradol or Phenergan for those PRN IV pushes! Simply slap a needle onto them, push out some saline and draw the med into the syringe and you're good to go!

Don't leave the nurses station without them! :)

EDIT: Our hep flushes are blue in color. Besides, you have to scan them and computer would alert you if you were mixing stuff up.

Our 3ml and 5ml NS flushes are stored in a drawer behind the nurses station. The hep and 10ml flushes are in the SureMed. If a patient doesn't have a 10ml/Hep flush assigned to their profile, we can do a "floor charge" over ride and draw it out.

[nursemary9, BSN, RN]

We have loads of 3 ml & 10 ml saline flushes on the floor & we USE tons of them too.

As someone mentioned, I too, right after report, grab a bunch & load them in my pocket;

We used to use the big bag & luer lock it as someone else mentioned & they did away with that saying it was an infection control issue.In fact, our Manager posted a huge sign saying that if she saw any more big bags like that, she'd write us up!!

The pre-filled flushes are more expensive, but they are awfully convenient & better as far as infection control.

[P_RN, ADN, RN]

Gosh $10 a flush? We didn't have them. I don't think they have them now either.

I would NEVER use a container (like the 500cc spiked bag) that had been accessed previously. Paranoia works quite well for me. I have known of nurses who diverted by putting the drug into a multiple use bottle in their pockets. If that vial were inadvertantly laid on the cart or desktop imagine what a 3cc flush COULD be. Every patient gets a "virgin" flush then the aliquot is discarded.

[CritterLover, BSN, RN]

the regular prefilled syringes arn't $10.00 each.

i can't remember what they actually cost, but i think it is a little more than 50 cents each.

i do know one of the outpatient areas that i work, we charge $1.00 for the ns and $2.00 for the heplock.

and in general, they arn't sterile. yes, they come wrapped up in a wrapper, but the syringe itself isn't sterile. the "contents" (normal saline) is, but the outside of the syringe isn't. so, you cannot place them on a sterile field (such as for cvl placement). i've used a few different brands of these, and one brand has it printed right on the sryinge "do not place on sterile field."

they do make sterile prefilled syringes, where the outside of the syringe is sterile as well, but they are extrememly expensive. we looked into getting them, but decided not to. so while it is possible that some facilities may carry the sterile prefilled syringes, they most likely are separated and not supposed to be used for "general purposes" (such as routine flushing).

[morte, LPN, LVN]

yellow heparin syringe=100 units per ml; blue= 10 units per ml

[Ophelia78]

When I was in school we drew up our own NS from individual 10mL vials. It was a no-no to draw from a bag or share it because of cross-contamination/sterility issues. When I graduated the hospital switched to pre-filled syringes. I loved them! We had 5mL and 10 mL syringes.

[ZippyGBR, BSN, RN]

we don't have prefilled flushes we just have ampoules of 0.9%nacl which when the top ois snapped off fit quite happily on a luer and will fill the syringe without a needle quite happily

[truern]

Besides, they are a convenient source for diluting Toradol or Phenergan for those PRN IV pushes! Simply slap a needle onto them, push out some saline and draw the med into the syringe and you're good to go!

Roy, there's a huge sign in our pyxis room that the prefilled flushes are not to be used for diluting meds. WHY, I don't know. Sterile NS should be sterile NS whatever the source.

[morte, LPN, LVN]

Roy, there's a huge sign in our pyxis room that the prefilled flushes are not to be used for diluting meds. WHY, I don't know. Sterile NS should be sterile NS whatever the source.

betcha some one put one down then forgot what they had done and used it as a flush....if you do use it to mix a med that way, need to label

[MS._Jen_RN, ASN, RN]

We used the individual NS bottles up until 4-5 years ago. The prefills are much easier and less risk of sticks. I would imagine much more cost for the facility, but in the long run cheaper than doing possible needlestick followups.

If there is a needle stick getting saline out of a bottle, the needle is not contaminated and would not require the follow-up like it would if it were a needle that had touched a patient. If it happens there are no tests to run or anything. It's just like a normal cut. I don't get it. We use prefilleds and love them. Also more fair, we had to charge a patient for a bottle and then it was used for other patients as a multidose bottle.

~Jen