IVPB tubing change

UM Review RN, ASN, RN · Jan 17, 2005

Yes, if both were compatible, and if the tubing was less than 3 days old, I'd backflush it with the IVFs and use it. This way you waste less of the antibiotic priming the line and this saves money.

PS Just curious, but what seems to be the problem with the nurses who don't do it this way?

nursepearl · Jan 19, 2005

i do the same as the above poster. Backflush and keep using it if it is less than three days old.

memphispanda, RN · Jan 19, 2005

I backflush. I don't see any reason to dump the tubing and get a new one. That's an additional access to the system that is totally unnecessary.

rnmaven · Jan 20, 2005

I have this argument with nurses all the time. In fact when I go on my rounds I find patients receiving multiple IVPB antibiotics with all three or four IVPB's and tubings dangling in the breeze. I throw them all out and back flush the last one connected with the primary solution, squeezing a little extra into the empty bag to make sure that the solution now in the tubing is just the neutral, primary solution. Then, I hang the new IVPB med.

I used to sell IV systems with Abbott Labs and sold also IV pumps for them. Their pumps (the Plum line) have a backpriming feature that not only allows you to clear air in line alarms but also allows you to backprime in between incompatible IVPB meds. It is a perfectly acceptable procedure......the problem is that most depts of nursing education have not incorporated it as an official P&P. Backpriming allows you to use that IVPB tubing for the same 3 days as the primary tubing. It maintains a closed system (less breaks in the system then you would have if you had to change the IVPB tubing with each antibiotic.) and is more cost-effective.

The only time I use a separate tubing is say for Prevacid which requires an in-line filter on the distal end of the IVPB tubing. I give that med and dispose of the whole tubing and filter.

When you find multiple IVPB tubings dangling in the breeze (oh, and usually not capped off in a sterile manner either.....did you notice?) tell that nurse or show that nurse the backpriming technique. Better yet, tell nursing ed to make it an official P&P.

Linda Payne · Feb 1, 2006

Hi guys this is my first time on this site and have a few questions. Our p&p has currently changed in our facility for primary and secondary tubing. Our policy is to change primary tubing every 96 hours and secondary 24. Can anybody out there give me any insight on this? I am told it is because of our new stat lock system which prevents jelco movement and avoids or decreases damage to veins. Also we do not have any pumps within our hospital that back primes. Many nurses are using new tubing for evey new antibiotic. Isn't it just as acceptable to flush the tubing and re-use tubing? :cool:

rnmaven · Feb 2, 2006

You don't need a special pump to backprime. If the secondary tubing is connected at the upper Y-site on the primary line, you just lower the secondary IV bag and the primary solution will backprime up the seconday line and flush it out. Like I said in my prior post.......just let it run into the empty bag, give a squeeze to the drip chamber and now the line is backprimed with neutral solution and ready for your next IVPB med.

I haven't heard of any studies supporting going to a 96 hour set change for in-hospital care. 72 hrs is the max I know of.

The P&P's that say to change the secondary tubing every 24 hours I believe are based on the fact that unless you backprime, you are breaking the system multiple times.

I would ask to see the evidenced based study that supports all of this. Bet they can't even supply one for you.

djcrocker · Aug 10, 2006

We are going to the backflushing process at our ICU. There have been many questions regarding incompatible meds. Most think that by backflushing you "rinse" the previous drug back into the old minibag. Others aren't sure the other drug is cleared well enough. What is the general opinion on this.

djcrocker

sister--* · Aug 21, 2006

We are going to the backflushing process at our ICU. There have been many questions regarding incompatible meds. Most think that by backflushing you "rinse" the previous drug back into the old minibag. Others aren't sure the other drug is cleared well enough. What is the general opinion on this.
djcrocker

Use the same tubing ONLY for the same drug. Don't mix tubings! Say you're giving two antibiotics at different times throughout the pt's stay. You need two sets of secondary tubing, one for each antibiotic. Your concern then is that your IV fluid is compatable with the medication being administered.

Also, our facility has gone to every 96 hr. tubing and sight changes as well.

Forgot to say that I was taught to back prime in school.

AngelsRN · Aug 30, 2006

We do tubing changes every 96 hours as well

rouge · Aug 31, 2006

Same here. I also do backpriming of the IVPB especially if for the same medication, in that I will not be worried of incompatibilities. But just in case I look at the compatibiltiy drug chart. Regarding tubing changes, i do it every 72 hours. In our facilty, we have stickers that we put on the tubing stating the date and time you need to replace it. But other nurses, sometimes forget to put on those stickers, so what I do is just replace entirely the tubings, because I don't want to guess if the tubings are due for change or not.........96 hours of tubing change? This is the first time i heard of it.......Are there available fact sheets/research studies published regarding this matter? I would appreciate if somebody will post on it or give us the website were we can read on it...Thanks:idea:

nursebuxom · Sep 4, 2006

my current facility p&p is back prime. each antibiotic does not requre its own tubing. we change tubing q 72h. secondary tubing has the same - q72h. I have worked in a facility with a 96 hour policy, they told us based on research, I never saw the research.