Different Piggyback Antibiotics, Same IV Tubing?? - page 2

by RachelRN89 20,510 Views | 61 Comments

Hey all, I just had a quick question about something I was taught in nursing school and was wondering if you learned the same thing, or practice this yourself. You have 2 different IV piggyback antibiotics (compatible or... Read More


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    I backprime every time I hang a secondary, however, I have never used the same secondary tubing for two different antibiotics.
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    I usually do it that way. Why waste a set of tubing? Of course it depends if the drugs are compatible.If they aren't I would likely change the tubing.
    joanna73 and JenRN30 like this.
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    In nursing school we were taught to use different tubing for each IVPB. On the floor that I work on we use separate tubing. For us, it's probably more out of habit now!
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    At one place I worked, the pharmacist made this the policy for secondary tubing. We used the same tubing for antibiotics.
    GaMommy81 likes this.
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    Thanks for posting this! After 3.5 years of nursing, I'd never heard of this until just last week at work, and was very skeptical at that time. However, after reading the linked articles, I'm considering converting to back-priming, after checkwing w/ my hospital's policy.
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    When I worked in the hospital, we carried 25 mL bags of normal saline. After an antibiotic was done, we hung this to flush the remainder through the tubing. We did not use separate tubing for every IV med the patient was on.
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    I always use the same secondary tubing for antibiotics and electrolyte replacements, unless the secondary is something that has major incompatibility issues, like dilantin or some antibiotic that doesn't work with D5 or 0.9 NS (pharmacy always labels those well for us).... Just backflush with 0.9 NS and hang! If you think about it, every time you disconnect and re-connect tubing you could be introducing pathogens. And, it's a waste of money and time.
    KelRN215, wooh, fsh1986, and 2 others like this.
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    Quote from RachelRN89
    Hey all,
    I just had a quick question about something I was taught in nursing school and was wondering if you learned the same thing, or practice this yourself.

    You have 2 different IV piggyback antibiotics (compatible or incompatible, doesn't matter) with NSS as the primary, and one is due at 1200 and the other is due at 1800. You hang the one due at 1200 then leave everything hooked up until you come back again at 1800 when the other antibiotic is due. Instead of getting all new secondary tubing for the new antibiotic, we learned to just back prime the NSS into the piggyback line a few times to flush what's left of the 1200 antibiotic into the old antibiotic bag, then disconnect and reconnect the new antibiotic. I was told that you don't have to worry about the 2 antibiotics mixing because you back primed with NSS and all that's left is saline in the now reprimed piggyback tube.

    Does anyone do this to save time and cost to the patient? Just wondering...thanks!
    Yes, this is acceptable at my facility. I guess you would have to check your policy though, or ask your ICN
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    Our facility used to have separate secondary tubings for each piggyback, but a few years back changed the policy to using one secondary line for piggybacks and using the back priming method. It's supposed to decrease the number if secondary tubings used and decrease line contamination from disconnection and reconnection. Either way, it's whatever your facility's policy says to do.
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    I can't help wondering if the cost of a secondary set is more or less expensive than the saline used to backprime. Further, the sited article is dated (copyright 2004...which at 8 to 9 years old would this source even be an acceptable source in most evidence based research papers?) and no longer complies with CDC recommendations. It looks as if the Infusion Nurses Standards of Practice were also revised in 2011. See new CDC recommendations here.... CDC - Patient Cleansing - 2011 BSI Guidelines - HICPAC

    Last edit by Serlait on Feb 10, '13 : Reason: spelling


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