disconnecting i.v. for a shower

rachel0609, ADN, RN · May 15, 2014

Does your facility have infusion caps? As long as a cap is secured on the infusion set and the pt iv cleaned with an alcohol pad before reconnecting there should not be a problem.

Asystole RN · May 15, 2014

I am very confused here.

The IV site has to be protected from water during the shower and I am not sure how that is accomplished without disconnecting the IV tubing. The other concern is of actual patient safety, a patient should never take a shower connected to an electrical device (if this is on a pump), but also the pump tubing can present safety issues relating to mobility.

Sterile syringe caps or alcohol impregnated syringe tip caps can be used to cap the tubing to ensure that it stays sterile during this time.

Edit: You have the correct idea though that the fewer times you breach the IV the less of a risk for infection, this time though the risk is less than other risks.

Aystole RN BSN, RN, CRNI, VA-BC

tinasuojoki · May 21, 2014

Thank you for your answers. We protect the infusion site from getting wet by wrapping a plastic bag around the arm, that works. If the patient is having a shower with the infusion running, then the pump is working on the battery and stays behind the shower curtain.We do have infusion caps we can use, but the question is which method gives more risks for the patient. We are working on a policy for the whole organisation so that the patients don't get confused by different ways of working.

Anna Flaxis, BSN, RN · May 22, 2014

I think it's okay for the nurse to use judgment as to which would be better.

Theoretically, every time you access a VAD, you risk introducing pathogens into the bloodstream.

And yet conversely by leaving the patient connected to the infusion, you risk the line getting caught on something and being pulled out, or limiting the patient's mobility and potentially increasing fall risk.

I think it's important that the nurse be able to weigh the risks vs benefits for each individual patient- and I think it's important for the nurse to be able to effectively communicate with the patient their rationale for doing things the way they do. Different nurses do things differently sometimes, and I think that's okay. I think most people are capable of understanding that there is more than one right way of doing things.

Asystole RN · May 22, 2014

The battery powered pump still works off of electricity... Unplugging something does not make it suddenly safe to use around water.

A quick answer to this question will be to consult your risk control manager.

Anna Flaxis, BSN, RN · May 23, 2014

The battery powered pump still works off of electricity... Unplugging something does not make it suddenly safe to use around water.
A quick answer to this question will be to consult your risk control manager.

True, but what do you suppose people on a 6-8 week course of IV antibiotics using an ambulatory infusion pump in the home setting do?

Asystole RN · May 24, 2014

True, but what do you suppose people on a 6-8 week course of IV antibiotics using an ambulatory infusion pump in the home setting do?

My home infusion patients are instructed to disconnect.

Even my continuous milrinone patients disconnect.

Anna Flaxis, BSN, RN · May 24, 2014

Not ours. They are instructed on how to shower safely with the device. Especially those with a recent history of IVDA.

lykadasmith · Jun 7, 2015

I agree that every time the line is disconnected from the patient, you risk introducing pathogens to the patient but have you found this in the literature? I am also working on a policy for our oncology unit but am having trouble finding the evidence in literature that supports the increased risk of infection from disconnecting IV lines. Has anyone found support from research?

Thanks for the help!!