I am working as an educator at a hospital in a developing nation. I found early on that the nurses very seldom flush their IVs (not after giving medication, not after insertion with blood draw), but just discovered that when they DO flush them, they use straight "sterile water for injection". A quick search here and on a drug site showed that this is absolutely not acceptable. I am working with the pharmacy to source suitable normal saline for flush instead--we have NS but it comes in 250 ml bags and 500 ml bottles only--but the immediate response was "We don't have that here [in this country]." After I showed the research showing that sterile water is not manufactured for use as flush and that it's actually dangerous, the pharmacist agreed to at least check if such a thing is possible.
But until such a time as I can convince the hospital to make this major practice change (and there may be significant financial outlay involved, I have no idea), what do you think I should do? Is it better for the nurses to continue not flushing the IVs anyway, or is it better to encourage them to flush with the sterile water until the day NS might be available?
A couple of times a year we have visiting medical teams from first-world countries come to do some advanced surgeries. I asked the pharmacist what those teams use for flushes (he'd said to me yesterday, when I asked for NS to flush a central line, "oh... I think we have some left from the last American team") and he claimed they use lots of things, NS that they bring, sterile water, even LR (?). That may just have been defensiveness, but if these American and Australian ICU nurses are really using sterile water to flush, I'm alarmed! Maybe they just haven't heard of it so assume it's okay.
