I am wondering if anyone has any information on how long other home health agencies are keeping bottles of Normal Saline in the patients home. We have 250/500/1000ml bottles forirrigation but are still wasting an awful lot. We are dating the bottles when opened but our current policy states discard after 24 hours. Thanks for the help.
Jun 28, '00
our policy currently is also to discard the saline 24 hours after opening. we try to use only the 250ml containers and on occasion have used unit dose3cc vials when provided by the pharmacy for small wet/dry dressings but those are expensive. I agree it does seem wasteful but I also think that this follows CDC guidelines.
Jul 9, '00
I know it's terrible to say but I don't know my agencies policy on saline. but the rule of thumb i personally use is the primary saline bottle remains refrigerated and is used to fill a spec cup from with the saline is actually use for the wound care. this prevents contamination of the saline. also most regs are based on hospital structure where cross contamination is a real risk. One thing I do know is we right all are wound care orders for clean technique not sterile which is a big difference. and in the home there is no increase risk of infection with clean verses sterile.
Jul 9, '00
Hi KT, our policies down under are usually 24hrs also (never seen one longer). I agree it is a waste of money throwing away unused portion & costly to use small sterile vials. Again, like barb we try to use the 250ml bottles.
HHnurse, are you warming your saline before the dressing? Don't forget, NS has no preservatives in it so should not be used for >24hrs, even if you decant it away from bedside.
When you say 'clean technique' are you meaning clean under shower & no touch technique (let air dry then cover with dressing). Nothing wrong with this, use it down here also, sometimes more comfortable for pt.
Jul 11, '00
By clean technique I mean using nonsterile gloves for the wound care. You do use minimal touching of the dressing materials. we do have pt shower with some wounds but not in general.
and if your orders are for clean verses setrile dsg change the saline doesn't have to be sterile. I've know of times when Pt's don't want to spend the money on saline make it at home with boiled water and table salt.
it's also common for pt to boil scissors and tweezers used in the dsg change between changes.
Jul 11, '00
Hi Beth, thanks for your reply. Boiled water with salt a great idea so long as it is not kept too long (24hr should really apply here). Always works for sticky eyes with kids. What did we do before autoclaving? boiling ofcourse!. Main problem is cross infection but if only one person uses the boiled instruments then it should be ok. Any other suggestions on how to avoid wastage of packaged n/s?
Jul 14, '00
Thanks everyone for the replies. I am still trying to figure out how to fix this wasteful situation at our agency. I had a patient just the other day tell me that he did not want me to throw the NS away because it was so wasteful. Technically, he paid for it and it is his.... then what? I can't be sure his cargiver isn't using it for the PM wound care even though they were instructed not too and why.
Jul 19, '00
Hi! Here in Florida we have lots of supply problems too because of the heat..BUT as far as normal saline..most of these problems were solved by going to spray saline for all wound care. They have long expiration dates like 11/01. They come in 3oz and 7oz and really are a great savings!
Jul 20, '00
If any one has information about the distributor of the spay saline bottles Ellen is talking about please email me. Thanks everyone.
Jul 21, '00
Our policy is to use normal saline for 30 days and we have passed all Public Health, JCAHO and OSHA reviews with flying colors! The only exception is when we mix the solution in the patient's home (which is rare) then we use it for only 24 hours.
Jul 24, '00
I found our policy on making saline in the home. after boiling the h2o and the jar in which it is to be stored our policy says 24hr at room temp and 1 wk in the frig.
I'm curious as to the rational of dumping saline after 24hr ( store bought sterile). in the home where cross contamination is not a concern. plain saline doesn't really encourage growth of anything that I'm aware of.
most if not all regulation are proably based off a hospital protical where cross contamination is a very major risk.
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