Changing the "flush" bag q24h

[PentelRSVP]

What is the rationale for changing the "flush" bag (bag of normal saline hung with the ABX if the patient does not have continuous IV fluids ordered) every 24hrs?

I know if has to do with infection control but the instructor to more into it. I tried looking up the INS standards but I'm not a member so no luck there.

[iluvivt, BSN, RN]

Yes you got it! The longer the IV fluids hang and are in use the greater the chance of the proliferation of bacteria and then the greater the risk of infection if any contamination should occur. As far as the CDC and INS..they do not have a specific hang time or fluids (mostly tubings) except for the ones I will list for you.

Manufacturer's recommendations need to followed for specific medications

• Parenteral nutrition (with or without lipids) hang time should not exceed 24 hours
  
• Lipid hang time should not exceed 24 hours /INS states 12 hours
  
• Propofol infusion hang time should not exceed the manufacturer's recommendations (which vary based on manufacturer) and should be changed at the same time as the tubing
  

Other fat based drugs and chemo drugs often have very specific hang times. The one that comes to mind is the fat based Amphotericin (Ambisone)

There are common pathogens that you will encounter that are related to various forms of intravascular systems. For example, in contaminated IV infusate you will see Tribe Klebsiella. Burkholderia cepacia,Burkholderia acidovorans,Citoobacter freundii and others.

Does that help?