IVPB antibiotics and saline locks.... - page 3
by PinkNBlue | 9,149 Views | 29 Comments
If your patient is getting IV antibiotics but does not need to get IV fluids in between receiving antibiotics, do you get new tubing each time you hang the antibiotic (let's say it's supposed to infuse every 6 hours over 30... Read More
- 0Quote from amoLuciaOh okay I understand. No problemPediLove - I should have qualified my response. Foremost, facility P & P should be followed and you're right - some things MAY be daily, q72 hrs, or weekly, or whatever per policy. But they must be dated and everyone providing care is responsible that the date falls within the correct allowable window of time. Many times I've heard from previous shifts (and my own shift staff)- "oh I wasn't responsible, day shift should have done (did?) it yesterday, blah, blah, blah". Not acceptable!
- 0Quote from eatmysoxRNAgreed. Why are their IVs no good?I usually hook them as a secondary to a bag of NS. My facility doesn't care though. I run the NS at kvo and set a low limit so all the antibiotic will infuse without infusing much saline.
Question to a poster above: a facility required IVs from ER to be changed within 24 hours? I've been in a facility where they required change upon admit if from a different facility but from the ER? Whew, I'd have to stick every patient. Seems like a waste of supplies if the existing IV were patent.
- 1I notice a few replies say that they change tubing for intermittent infusions q 24 hours. This is one reason why the INS annoys the $%^ out of me. The INS is unaware of the terminology used in infusion practice and refers to "intermittent" tubing as tubing that is intermittently connected, rather than intermittently infusing. The INS does not actually recommend changing intermittent tubing every 24 hours, yet this is how it is commonly understood, which actually increases contamination risk.
It's important to note that the evidence does not support this, in fact it suggests that this is bad practice. The INS claims that the many studies that showed additional or equal risk with less frequent tubing changes did not include tubing that was intermittently connected and disconnected although if you actually read the studies they clearly included intermittently connected tubing, they only excluded antibiotic tubing (for obvious reasons). Most studies showed no additional risk with less frequent changes, and 4 showed a significant increase in infections when tubing was changed more often, the INS recommendation defies this evidence without any evidence of their own to refute it.
- 2Current evidence shows that pre-hospital starts are just as good as hospital/ED starts. Back in the early 80's there was evidence the pre-hospital starts were more likely to be contaminated, based on a few studies all out of Charity Hospital in NOLA which involved a fairly small number of EMT's and Medics. Gloves were not typically worn, no skin asepsis was performed, and the IV was a metal needle just taped in place (no dressing). Today pre-hospital starts are held to the same standards as in-hospital starts, so the advantage of a new site needs to be weighed against the risks associate with a new start (introducing bacteria, nerve damage, vein damage).
- 0Aug 25, '12 by kitty13Good technique! Yes always follow your hospital P&P but as Aurora77 said that 100ml bag is cheap, it delivers the rest of the antibiotic in the iv line to your patient so they get all the med. Even for intermittent this is best nursing practice and it clears your tubing of any residual med incase you are re-using tubing.