Anyone NOT use prefilled flushes?

[Mommy TeleRN]

I have experience at 2 hospitals as a student. One uses prefilled flushes (as I imagine most hospitals do) One does not. Supposedly it is cost saving. You have to open the syringe, wipe the tip of the saline bag with alcohol, fill the syringe, and cap it (they have the little caps in a package) and if you are prudent, slap a NS label on it. Just seems so odd to me to share a saline bag to fill flushes. Is this standard practice anywhere else?

[SouthernLPN2RN, MSN, RN, APRN, NP]

The hospital I'm at uses prefilled.I can't stand the way they do it though. I like the idea of prefilled, but they keep them in the pyxis with the narcs and if a new pt hits the unit that needs a jelco, we have to pull them under someone else's name.

[crb613, BSN, RN]

We have the 10ml prefilled too. Ours are kept in a drawer in the med room.....easy to get, & I usually carry a few w/me at all times. We do run out sometimes then its the ns bag....for community use. Uhmmm no thank you, I will get get my own & keep it to myself!

[lorster]

The hospital I'm at uses prefilled.I can't stand the way they do it though. I like the idea of prefilled, but they keep them in the pyxis with the narcs and if a new pt hits the unit that needs a jelco, we have to pull them under someone else's name.

That is ridiculous. You should be able to override that.

[Gromit]

Ours uses prefilled saline (10) and we also use the prefilled heparin (flush) -the saline has white labels, the heparin syringe blue ones -ditto for the endcaps on the syringes.

firstyearstudent -if those 3ml syringe flushes are small (narrow barrel) then the other nurse is right, these can cause damage to picc lines (and I agree, whats the point of the three ml flush? PICCs take 10. Guess it would work for a peripheral iv...)

[sister--*]

We have the 3cc prefilled syringes as well as the 10cc ones. Both are the same diameter. 3cc is just a 7cc's shorter syringe so it's pretty "stubby."

I like to use the 10cc flush syringes for almost everything that doesn't take a 20 cc flush according to my facility protocols. About the only thing IMO that the little 3cc flush is appropriate for is clearing the port after giving an IV med.

[meandragonbrett]

Keeping them locked up in the drug vending machine is absurd. It's also crazy to charge a patient for a flush even if it is prefilled. Some patients have so many flushes used on them it could easily add up to 500 bucks a day (somebody mentioned $10 per flush) That's kind of like charging everytime you flush the toilet.

We don't use heparin flushes so confusing the two is not an option.

[all4schwa]

We spike a 1L or 500ml bag with a leur lock clave. It works for us, we go through the big bags, if we had prefilled, we'd probably run out. Theres not a problem of needle sticks because they're leur locked, and it makes convienent for diluting meds. On our unit we keep them in the medroom and in the icu we keep them in each patients room.

[Ivanna_Nurse, BSN, RN]

In clinicals, I have seen pre filleds in 3 different ways.. either in a big ole box for you to grab and use as you wish, locked in a med cart and there is a charge slip filled out for each, also locked in the pyxis- its inconvenient to work with the pyxis for flushes; especially if you need more than the allotted amount.

[truern]

We use the 3ml and 5ml prefilled NS flushes and they're stored in one of the supply bins. Our heparin flushes are in the pyxis and would be difficult to confuse with the NS with all the yellow warnings and yellow cap.

[kattben]

the hospital that I work at also uses 30ml containers of saline. Each pt gets there own container when their meds come up from pharmacy

[Hoozdo, ADN]

Keeping them locked up in the drug vending machine is absurd. It's also crazy to charge a patient for a flush even if it is prefilled. Some patients have so many flushes used on them it could easily add up to 500 bucks a day (somebody mentioned $10 per flush) That's kind of like charging everytime you flush the toilet.

We don't use heparin flushes so confusing the two is not an option.

:yeahthat:

One of the first things I do in my shift is go to the Pyxsis and yank out 10 flushes for each patient. That's a 100 bucks each right there. Since most of my patients have central lines and/or PICCs I am back getting flushes in a few hours. Sometimes I can't even pull flushes for a pt that doesn't have them in their profile........so I have to charge a different pt for their flushes. Totally ridiculous!

[pepsihla]

I'm a prefilled flush junkie. The prefilled NS 10cc flushes are individually wrapped, sterile, no preservatives and ready to use. I love them, they save me time.