Published
I remember all through school having it drilled into my head that TPN was to infuse by itself and never to piggyback ANYTHING else into it. Where I work RN's consistently piggyback numerous drugs into the TPN line. Most often it is antibiotics, pepcid, morphine and zofran/phenergan. I am currently searching for info on this from the internet, but in the mean time would like your input. Thanks!
RedWeasel, RN
428 Posts
yeah! true I have never seen a nurse replace an old cap, or not wear a mask-or have the pt wear a mask. Use sterile gloves....I suppose it could happen but when you even go to change the dressings everything is in a kit at our place. If everything is provided for, how can you be sloppy, right? We know how easy it is to get, say, a PICC clotted off...pts with SDHs or cranis who aren't on anticoagulants are famous for it on our floor. Our orders say to flush at least q 24 hours. We know if it isn't flushed every shift it will most certainly clot off and then it is alteplase city! Which takes a long time to work. I think it goes back to orientation of nurses to a facility and continuing education, and just communication between coworkers-don't be afraid to ask each other questions....when in doubt don't chicken out--better to look a little uncertain now (ask does the pt have to wear a mask too?--even if you asked the same question last month) than to look really dumb later when you have been caught changing a dressing while the pt is coughing maskless onto the site, who later on comes down with a nice 104.0 temp....and when the PICC is pulled there is yellow stuff on the end...and when pp ask you 'dumb' questions don't treat them dumb-I just see more and more lately they forget how many questions they asked when they first started (I should take notes)...going to bed I ramble...