Changing IV tubing with half full bag?

[erint91DC]

I'm aware of how to change the IV tubing (primary or secondary) with a new IV bag.

Say you come onto shift and discover that the IV tubing is 2 days past the date it should've been changed. Would you wait until the bag needs to be changed? Or would you just prime a new bag, hang that one, and discard the old one?

I think you would prime and hang a new bag, but isn't that a waste? I guess wasting some IV solution is better than postponing the tubing change even later.

What do you think?

[ixchel]

Well.... You've already saved money on the tubing by having it sit an extra 2 days, so maybe it evens out a little? :)

At two days, I vote pull it all down and start over. I'd probably just pull it and start a new bag regardless of the time past expiration and starting the fluids. It sucks, but so does sepsis and phlebitis.

[mrsboots87]

I would vote for just wasting and starting over. IV infections are no joke and at two days, if the tubing is truly contaminated from too long of use, so is the fluid bag that's hanging. So continuing to infuse contaminated fluid just seems like a bad idea. One HAI from IV tubing costs way more than the wasted bag.

[KelRN215, BSN, RN]

Yes it's a waste but the cost of treating sepsis would be infinitely greater and the hospital would have to eat the cost of it because it would be an infection caused by the hospital/a breach of standards.

I'd change the whole thing as soon as I noticed it.

[akulahawkRN, ADN, RN, EMT-P]

If hospital policy says they go after 96 hours and there's no order allowing it to stay in place longer than that, I'd say to change the tubing and half-empty bag entirely. IV bags and tubing are pretty darned cheap... and a whole lot less expensive than treating for a hospital-acquired sepsis. If I were a hospital accountant, I'd much rather pay > $20 for new catheter, tubing, and fluids every 4 days than pay thousands for additional days, medications, high-level care, etc. From a cost perspective, infection control perspective, it's a no-brainer. Change it out.

[ParkerBC,MSN,RN, PhD, RN]

I would get rid of it. Suppose the tubing is bad and bacteria migrated to the IV solution- if you use new tubing with a contaminated bag, it defeats the purpose.