CVC mess-up?

Nurses General Nursing

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Hi, new RN here, and I am hoping someone can help set my mind at ease/ advise me about something that I did on my shift today, that I can't get off my mind.

When disconnecting a central line IV infusion, I inadvertently disconnected the needless access device along with the tubing, and didn't realize. Then I flushed it and capped it, all correctly and safely, just without the actual device in place (directly into the port). I clamped it safely before completely emptying the flush, and it remained clamped and capped throughout the shift.

Later, the next nurse alerted me that I had disconnected the access device and showed me. My heart dropped into my stomach, but neither of the more experienced RNs I was working with seemed to think any ill effect could come from it, since it was clamped and clean. But one of the RNs did question whether air could get in without the access device in place. I'm just so restless thinking about it, and hoping to get some clarity about what I should have done differently or what I can do.

Thanks so much (at the time I left, having no access device for 7 hours, the patient had no signs of trouble)

Thank you so much!!!

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Agree w/ J. Seizure!

But one of the RNs did question whether air could get in without the access device in place.

Note to self: Not likely a strong "go-to"/resource person!

Take note of who the experts on your unit are, as you grow in your role.

Hope you're feeling better about all of this!

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Specializes in Infusion Nursing, Home Health Infusion.

OK got it you used an IPA port protector on the end of the hub. While not ideal you DID cover the port and protect your patient. Before needleless connectors we still had a cap attached to the hub. We even had two kinds, a slip loc (very risky) and a luer loc in which a needle could pierce. You either did a direct hub to hub connection or you actually attached a needle onto IV tubing and pierced the cap. Now we have NCs and when you are ready you can learn about the three types on the market. Right now you need the basics and I think I can find you something that may help if I may.

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Specializes in Med-Tele; ED; ICU.
Note to self: Not likely a strong "go-to"/resource person!

Take note of who the experts on your unit are, as you grow in your role.

Good point, worth emphasizing.

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Just wondering, what makes you guys say this?

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Yes, you most certainly may:)

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Specializes in Pediatric Critical Care.

arieseff,

If you hit the "quote" button, it will put a quote of who/what you are replying to in your comment. It makes it easier for everyone to follow the conversation. :cat:

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Our docs throw in lines and don't put caps on, forget to clamp, etc. It's awful. You recognized your mistake, and will learn from it (unlike them)! Clean, clamped, connected -- your 3 C's for CVCs!

wow, that's crazy! and you're absolutely right i will learn from it. this experience humbled me in ways i didn't know i could be humbled

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arieseff,

If you hit the "quote" button, it will put a quote of who/what you are replying to in your comment. It makes it easier for everyone to follow the conversation. :cat:

thank you!!

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Good point, worth emphasizing.

Just wondering, what makes you guys say this? (about that RN being not being a good go-to)

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Right now you need the basics and I think I can find you something that may help if I may.

yes you absolutely may!!

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Just wondering, what makes you guys say this? (about that RN being not being a good go-to)

Because of what J. Seizure said:

Now, times have changed and needle-less connectors are great, but what it sounds like you did was basically what everybody used to do before those connectors existed.

I agree it sounds like you pretty much did what was generally considered proper procedure not that long ago, and was not associated with high "air-related" complications. In addition, this person wonders about air entry complications multiple hours after the fact when the patient is doing just fine - - also kinda suggests a lack of knowledge/reasoning. There may be a limited perspective and understanding there, that's all. And in fairness, there may not be and it might've just been an off-hand comment.

Anyway, you've learned something new with no harm done! All's well. :)

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