Quote from MunoRN
I think it's 96 hours minimum now.
I've heard a lot of interpretations of the INS standards but not that one yet. My first question would be why is the secondary tubing being disconnected, or is it. Do you change all lines carrying medications every 24 hours, even if they are continuously infusing and continuously connected?
Yes. The secondary is disconnected from the primary fluids, and capped. Due to multiple secondary infusions over a period of time, or a practice issue to just have primary running--nurses will do it both ways (but I have also seen the primary "back up" into an empty secondary, this avoids the issue)And depending on pump, free flow...
Either the tubing is primed and reused if it is within the 24 hour time period. All have to be labelled. And our policy is still 72 hours for fluids, as it coordinates with the IV rotation. And of course, it there's no fluids just IV infusions, then the primary is taken off and capped for reuse or a new set if after 24 hours, IV becomes a SL.
I think the bottom line is the push to reduce/eliminate hospital acquired infections. When we were surveyed, there was checking of all IV sites that they were dated and timed, that all IV infusions were dated and timed, and if we all knew the policy of same. To take it one step further, then it was checked that each person with an IV had a skin integrity care plan, and that in fact it was looked at, reviewed and initialed. (as well as each patient having an alteration of bowel pattern care plan if they were on any pain meds, reviewed and initialed as indicated--story for another thread HAHA). Most EMR's do this from a "problem list" perspective now.
From what I have observed, the bottom line is that insurances will not and do not pay for hospital acquired infections. And IV site issues can ("can") be the result of not changing the tubing. With that being said, the on off of a secondary is certainly a risk, however, it is a practice thing at my facility.