IVPB antibiotics and saline locks....

[PinkNBlue]

If your patient is getting IV antibiotics but does not need to get IV fluids in between receiving antibiotics, do you get new tubing each time you hang the antibiotic (let's say it's supposed to infuse every 6 hours over 30 minutes)? So once that 30 minutes is up, you disconnect the IV tubing from the patient, leaving just the saline lock so you have access for the next dose and the patient isn't tied down having the IV running unnecessarily. New tubing? Or do you plug the end of the IV tubing into a cleaned port of the IV tubing? Just curious...

[RNsRWe, ASN, RN]

Clearly the answer is in your own facility's P&P manual. Last hospital I worked, which I left a year ago, had the policy that all primary tubing was good for three days, all secondary, two days (or, 72 hours and 48 hours, respectively). However, if there was no saline line running and, in fact, the "primary" was single-dose antibiotics q whatever hours, that tubing was to be changed q 24h.

Facility P&P makes the decision :)

[prussell]

I've been taught that tubing of intermittent IV infusions must be changed every 24 hours, regardless of any add-on devices. One very important thing to remember is not to contaminant the end of the infusion tubing. I would use a sterile cap to cover the end so that it doesn't become contaminated. If contamination is suspected or when in doubt that the integrity of the end of the tubing has been compromised, it will need to be changed immediately. It's always good to ask if in doubt.

[eatmysoxRN, ASN, RN]

I usually hook them as a secondary to a bag of NS. My facility doesn't care though. I run the NS at kvo and set a low limit so all the antibiotic will infuse without infusing much saline.

Question to a poster above: a facility required IVs from ER to be changed within 24 hours? I've been in a facility where they required change upon admit if from a different facility but from the ER? Whew, I'd have to stick every patient. Seems like a waste of supplies if the existing IV were patent.

[KaeliF]

It depends on your facility's policy. Our policy is that intermittent infusions need tubing changes q24h.

[iluvivt, BSN, RN]

When you have any type of locked VAD and you are administering IV medications intermittently you will use primary intermittent tubing. According to INS these type of tubing should be changed every 24 hrs b/c of the connections and disconnections are on a more frequent basis they are more likely to cause and infection. The CDC does make make a recommendation on this issue. You should use a sterile end cap on the end of the tubing that is designed for this purpose and not something like the cap on an NS pre-fill and always scrub your needleless connector for 10-15 seconds with alcohol or per your policy.

[One1, BSN, RN]

a facility required IVs from ER to be changed within 24 hours? I've been in a facility where they required change upon admit if from a different facility but from the ER? Whew, I'd have to stick every patient. Seems like a waste of supplies if the existing IV were patent.

Here it is 24 hours for a pre-hospital stick, and 72 hours for ED sticks. I agree, an ED IV start should be as good as a start from any floor.. However, we also label our pre-hospital IV starts both at the site and in the documentation as field starts, so the floor nurses know where the IV was started.

[abiklags]

Question to a poster above: a facility required IVs from ER to be changed within 24 hours? I've been in a facility where they required change upon admit if from a different facility but from the ER? Whew, I'd have to stick every patient. Seems like a waste of supplies if the existing IV were patent.

yup. I heard it from a number of nurses there on a number of different units. I don't know the reason why and in hindsight, I should have asked. I have read the pre-hospital sticks are changed quicker than in-hospital sticks but as you said, why is an ER IV any different than any other IV? now that you mention it, it really does not make sense.

[eatmysoxRN, ASN, RN]

If I were a patient there I'd refuse. It usually takes a couple of tries to get one on me anyway. Patients feel enough like pincushions without adding extra IV sticks.

[PediLove2147, BSN, RN]

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.

Oh okay I understand. No problem :)

[PediLove2147, BSN, RN]

I usually hook them as a secondary to a bag of NS. My facility doesn't care though. I run the NS at kvo and set a low limit so all the antibiotic will infuse without infusing much saline.

Question to a poster above: a facility required IVs from ER to be changed within 24 hours? I've been in a facility where they required change upon admit if from a different facility but from the ER? Whew, I'd have to stick every patient. Seems like a waste of supplies if the existing IV were patent.

Agreed. Why are their IVs no good?

[PediLove2147, BSN, RN]

Agreed. Why are their IVs no good?

ETA: just saw your reply, you're baffled too.

[MunoRN, RN]

... The CDC does make make a recommendation on this issue. .

I think you meant to say the CDC does not recommend changing tubing q 24 hours.