New policy on my unit is to hang all ATX using secondary tubing, back flowing the tubing, then setting the volume to 20 ml greater than the volume in the spiked med. The rationale is that this will insure the patient receive the total volume of the antibiotic, rather than leave some of the infusion sitting in the secondary tubing. It is ok to use the same secondary tubing for antibiotics that are compatible. If running incompatible ATX, a second primary solution, and piggyback would need to be set up. Though there is no official policy yet, on using secondaries, I have heard that in the ICUs in my hospital they have been using the back flow technique for years, but even take it a step further. In the ICU, they only use one (1) secondary tubing set, and infuse all meds through it, compatible or not, as long as they are compatible with the primary solution. Once the secondary med is empty they back flow the primary solution into the empty piggybacked bag, thus flushing the secondary tubing. This allows the RN to administer any medicine, compatible or not, even colored infusions such as iron, using the same secondary tubing, as long as the med is compatible with the running primary.
We run all drips, heparin, insulin etcetera separately. This practice is only used for intermittent infusions. Do you agree, or see any issue with using the same secondary tubing for all medicines?