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Closed Med System to prevent central line infections

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I was hoping that people could tell me what their NICUs use to prevent central line infections (PICCs, UVs, CVLs, etc). A closed medication administration set was an idea my NICU was exploring. If anyone does use them in the NICU can you give IV push meds (caffeine, phenobarb, ampicillin, etc) through them? Any help or infection control suggestions would help!

RosesrReder, ASN, BSN, MSN, RN

Has 18 years experience.

We use clearlink. We are now trialing the ones with the concave valve (can't think of proper name). All needless by Baxter

littleneoRN

Specializes in NICU. Has 6 years experience.

We use a closed medication system, and I like it. I like that you can draw up flushes for your line without breaking the line. I'm not sure what you are asking about pushing medications. We don't really push medications except for like emergency paralytics or code meds. Those we will push into the nearest port or the med line if it's available. It's just important to remember the priming volume below the port because most meds would just sit in the line and need to be flushed to reach the patient in a timely manner. Our system has an anti-backflow so that injected meds will not flow backward up the line from the injection site. We typically hand push the med into the line (except PICCs and Broviacs) if the volume is less than the priming volume and then program a flush for the length of time we would give the med over. Do you give your caffeine and ampicillin push? Our medline has a trifuse at the bottom so stable patients will have their TPN and lipids running into it at the bottom. Obviously we don't put any drips on this trifuse since the point of the system is for intermittent IV medications. You could also have this system hanging without any infusing fluids and then heparin or saline lock the IV between meds from one of the tails on the trifuse. I really haven't had any issues with this system, and we've been using it for awhile now. I don't know who makes it.

We do push our amp. and caffeine as well as many other meds due to the small doses needed. The pushes are usually slow pushes (5-15 minutes) but the meds are pushed none-the-less.

littleneoRN

Specializes in NICU. Has 6 years experience.

Hmmm...I guess a slow push over fifteen minutes isn't that different. We flush them in over 30 minutes, but we put them on a syringe pump for reliable, non-hurried administration that allows us to walk away and do something else. The doses are small, but not for the patients. Do you put longer running meds like vanco or gentamicin on a pump?

EmilyPeruana

Specializes in NICU. Has 3 years experience.

i dont know what our's is called...we call them 3-way or 4-way manifolds...but in terms of preventing blood stream infections, this is what we do:

-we scrub the port 6 times, 360* with CHG, wait 20 seconds to let it dry, then flush, give meds

-every 3 days, we do entire line changes (right down to the port at the end of the picc line or broviac, but we do them in groups of 2 with one sterile person and one clean person

-keep lines away from baby's stoma, ostomy bag, and diapers....and we're encouraged to keep meds pumps on a pole on one side of the bed and feeding pumps on a separate side of the bed

good luck