first shift of preceptorship: told that my IV priming is wrong - page 5

by seks 10,126 Views | 53 Comments

The hospitals in this city use the Alaris pump and this kind of Alaris infusion set: Prior to my preceptorship, I've always twist that end cap a little bit so that the IV solution can dribble out while priming. However,... Read More


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    samadams I wish I could do more than just like your post. Common sense....it really is not so common is it? lol.
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    But after removing a cap, you shouldn't recap with the same cap as caps are single use only. Once removed it should be pitched. There are reasons educators like to see things done in a certain way as it produces the best patient outcomes. Are there other ways of doing things.. sure.. but they may not be the safest for your patient. It is sad when one dismisses the expert advice of another when that person was just trying to help. I won't ever profess to be an expert in wound care, or OB-GYN, but Infusion Therapy is my specialty and the knowledge imparted is from years of study and researching outcomes. After all, shouldn't nurses help other nurses with their experience and knowledge...Yes, I think we should, however, it will only benefit someone if they have ears to hear.
    redhead_NURSE98! likes this.
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    I can't believe the preceptor made a big issue out ot this; but this shows a lot of the ridiculousness in nursing.

    The OP is sweating the small stuff b/c the preceptor is being a control freak over this kind of thing.
    That's a little harsh. The preceptor corrected the OP. Part of being a preceptor. She told her once. That is not being a control freak.
    roser13, Altra, chevyv, and 2 others like this.
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    Quote from equestriRN
    We use the same tubing. There is no need to remove the end cap as it is "flow through". There is a chance, however small, of contamination if the end cap is removed or loosened - especially if, like me, that end hits things like the sink or garbage when I'm priming the line (particularly in a rapid response situation)
    Yeah, I was going to say this as well. I've never needed to mess with the cap until I connect it to the patient- you can prime it fully with the cap completely in place.

    OP, are you familiar with the phrase "when in Rome"? You are in Rome now. Do as the Romans do.
    chevyv and KelRN215 like this.
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    Quote from IVRUS
    But after removing a cap, you shouldn't recap with the same cap as caps are single use only. Once removed it should be pitched.
    I have a question about this. In another long-dead thread, we all talked about using the saline flush caps to cap off a line of, let's say antibiotics, after they've infused. (Take cap off, being careful to not touch the sterile end, capping the end of the tubing, then flushing with aforementioned NS flush.) I understand "single use only" but what is the infection risk and where does it come from?
    psu_213 and wooh like this.
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    Quote from dudette10
    I understand "single use only" but what is the infection risk and where does it come from?
    This. If all the cap touches is air between being taken off the line and being put back on, WHERE does the infection risk come from? Because taking a new cap out of it's packaging, it's going to touch the same air between package and line as the cap touched between line and again line.
    I get that it says "single use only" but it's not like a spy message that the cap is going to self destruct after one use.

    Oh, and to those that think you don't have to remove the cap to prime, with some tubing you do have to take the cap off the end (or at least loosen it) to get the tubing to prime. Not true of all tubing, but the tubing we currently use requires it.
    redhead_NURSE98! likes this.
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    Quote from wooh
    This. If all the cap touches is air between being taken off the line and being put back on, WHERE does the infection risk come from? Because taking a new cap out of it's packaging, it's going to touch the same air between package and line as the cap touched between line and again line.I get that it says "single use only" but it's not like a spy message that the cap is going to self destruct after one use.Oh, and to those that think you don't have to remove the cap to prime, with some tubing you do have to take the cap off the end (or at least loosen it) to get the tubing to prime. Not true of all tubing, but the tubing we currently use requires it.
    OP is using Alaris pumps. I've never used Alaris tubing that requires the cap to come off.
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    We use Alaris and I noticed that certain tubings will not dribble further with the cap on once the fluid reaches the end. So, if there is a big pocket of air, you'd have to open the cap.

    It's unfair to decide what is right way or wrong way, because each hospital looks at the evidence and decide what product to purchase and write their policy. A nurse from one institution will do differently from another nurse from somewhere else.

    Our unit has strict policy of capping the IV line with a single-use cap each and every time. Discouraging the re-cycling (or using the cap from your flush) is just an attempt at reducing the opportunities of contamination as much as possible. The outside surface of the saline flush or already-used cap is no longer sterile. By touching it and using it to cap your line, you're increasing the chance of the male end of the tubing to be contaminated. By opening a sterile package and using the fresh cap right there, there's less risk.
    samadams8 likes this.
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    Quote from Pepper The Cat
    That's a little harsh. The preceptor corrected the OP. Part of being a preceptor. She told her once. That is not being a control freak.
    To even make an issue out of this, from the "preceptor's" standpoint, is totally control freakish. Way TOO common in nursing.

    > than 20 years in this field. Seen it more times than I can count. I told OP to suck it up though; b/c too many "preceptors" are not able to consider that there are various ways to do things, and a lot of that has to do with the need to be in control.

    Lots of severe insecurity in nursing. It just is. Sad really.
    Last edit by samadams8 on Oct 16, '12
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    Quote from hiddencatRN
    Yeah, I was going to say this as well. I've never needed to mess with the cap until I connect it to the patient- you can prime it fully with the cap completely in place.

    OP, are you familiar with the phrase "when in Rome"? You are in Rome now. Do as the Romans do.

    As I said, sometimes it's fine other times it's not. The key is to get out air and maintain aseptic technique. This can be achieved both ways. You just need to be careful.


    Angels on the head of a pin.


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