IVPB antibiotics and saline locks....

KBICU · Aug 23, 2012

Flush the saline lock with 3 ml NS before any med administration. New tubing for antibx and bolus meds (if your patient needed a gram of magnesium for example) every 24 hours. Disconnect from the patient, cap the tubing of the antibx and flush the saline lock with 3 ml NS.

KBICU · Aug 23, 2012

And saline locks get changed every 96 hours (use to be 72...just recently changed) or if they stop working ie clot, infiltrate or get removed by mistake. Hope this helps!!

amoLucia · Aug 23, 2012

All tubings MUST be dated as they are good for only 24 hrs. During an audit or survey, there could be be a meltdown if no date is found (same goes for enteral feeding tubings, IV drsgs, oxygen equip, etc). If there's no date, it really should be thrown out/changed. And that's an unnece$$ary wa$te that the facility has to eat the co$t.

eleectrosaurus · Aug 23, 2012

Shouldn't you hang a 500ml bag of NS and run 20 mls after the abx so the pt gets the remainder in the tubing, plus it doesn't dwell in the line?

PediLove2147, BSN, RN · Aug 23, 2012

All tubings MUST be dated as they are good for only 24 hrs. During an audit or survey, there could be be a meltdown if no date is found (same goes for enteral feeding tubings, IV drsgs, oxygen equip, etc). If there's no date, it really should be thrown out/changed. And that's an unnece$$ary wa$te that the facility has to eat the co$t.

All tubing? We change ours every 96 hours at my hospital. Except for tube feeding and TPN, those are both changed every day.

Jory, MSN, APRN, CNM · Aug 23, 2012

Medication tubing is good for 72 hours, per the last facilty that I worked for.

I always date mine and flushed with saline to make sure all the medication was out. IT IS NOT NECESSARY to get new tubing for each medication if the medications are compatible with each other and you are not leaving medication in the line.

PinkNBlue, BSN, RN · Aug 23, 2012

Ok thanks. I've been doing it correctly but heard some things so I was just curious what some of you guys do. :) Thanks for the replies!

Aurora77 · Aug 23, 2012

Another thing that I do (check your facility's P&P, this is OK with mine) is to hang a 100 mL bag of NS on the primary and set it at 10cc/hr, then run all antibiotics as secondaries. I work nights, so this works fantastically for those patients who might be getting several doses during the night. I don't have to come in and wake them up often to hook or unhook their fluids. It makes for happier nurses and happier patients. Plus, it's cheaper for the hospital. We're allowed to hang our primary tubing for 72 hours, but the intermittent infusions have to be changed daily. It's way cheaper to change the secondary tubing than the primary.

Columnist · Aug 24, 2012

Moved to Nursing and Patient Medications

amoLucia · Aug 24, 2012

PediLove - I should have qualified my response. Foremost, facility P & P should be followed and you're right - some things MAY be daily, q72 hrs, or weekly, or whatever per policy. But they must be dated and everyone providing care is responsible that the date falls within the correct allowable window of time. Many times I've heard from previous shifts (and my own shift staff)- "oh I wasn't responsible, day shift should have done (did?) it yesterday, blah, blah, blah". Not acceptable!

Thank you.

abiklags · Aug 24, 2012

the hospital for clinicals as a student had the following. Saline lock was good 96 hrs unless infiltrated/pulled out/ clots or is from the ER (has to be changed with in 24 hrs)

Primary tubing for fluids are good 96 hrs and must be labeled with the date it has to be changed

secondary tubing/tubing used for meds must be changed every 24 hours. when the med was done, the tubing was disconnected and capped until the next use and the saline lock was flushed (if the pt was not on fluids)

TPN tubing came up with the TPN and was changed with the bag

not sure what the policy was for tube feedings