Labeling IV lines

[moonshadeau, ADN, BSN, MSN, RN, APN, NP, CNS]

I am curious as to what is the practice at other hospitals regarding IV tubing labeling of the drug in the line. Our critical care areas label the name of the drug in the tubing at the distal end.

Do you practice this as well? Do you have a policy in place or know of reference material that supports this practice? Other thoughts?

Thanks,

Moonshadeau:no:

[RNperdiem, RN]

Yes.

When there are multiple drugs infusing, it is important to know exactly what is going where.

I label lines at the distal end. I always like to know where the maintenence infusion port is in case I need to push some emergency drugs.

[NotReady4PrimeTime, RN]

I don't know that we have a policy, but we definitely have a standard practice. We label the tubing at the distal end (I like to wrap it around the hard part where the tubing connects to the Luer lock... it stays there better) and we also label the pump with whatever it's infusing. We use orange med tickets so we can see from the foot of the bed what is running and what the concentration is.

[BlueEyedRN]

Not a policy, but definitely important. If I come in to a big tangle of IV tubing and pumps, the first thing I do is go through and label everything, make sure everything is compatible, etc. It would be horrible to push 10 mls of a med through what I thought was NS, but turns out to be an insulin drip or to be inlined into an insulin drip further down. I don't understand how people can do without labels. I usually stick the labels at the port rather than the distal end. And then I make a chart of what is going in where to tape at the nurses station so I can quickly figure out where to add something or if I need to start a new IV.

[diveRN]

Our pumps have electronic labels for the Guardrails drugs so it makes it easier to look at when you have 8 channels infusing something...

We also label at the pt.

[moonshadeau, ADN, BSN, MSN, RN, APN, NP, CNS]

Thanks to all. There has been much discussion at our hospital that this practice will no longer be allowed. There is fear that by labeling lines, nurses will not take the time to trace their lines back. I believe that labeling lines is a safety issue in the critical care setting, but it has been a really tough sell.

[Spatialized]

I'm not a critical care nurse (PCU/Step-down) but if I have multiple lines running I too label lines and pumps. It's not policy or protocol, but to me it just makes sense and that's only with 2, maybe 3 lines...I wold think it wold be more followed for more.

[NotReady4PrimeTime, RN]

When I've got 20+ infusions going you can bet I'm labeling. Standard practice or not. We might have epi, norepi, vaso, nitroprusside, furosemide, amiodarone, heparin, insulin, TPN, tacrolimus, ganciclovir, morphine, midazolam, albumin and an assortment of intermittent meds all going at the same time on a single patient. Which ones am I likely to want to push? Maybe the albumin...

[Guest193822]

It's not a policy but it's just a common nursing courtesy.

It's the best thing to do when you have tons of meds tubes lines etc. My hearts, septic, & neuro pt's all get them labeled.

Pumps & lines are labeled. It just helps with idenification of meds & location of things.

[MaryAnn_RN]

We label each infusion line with the drug label, and also a 'change date' label.

[NotReady4PrimeTime, RN]

We do too. As an example of how important it can be to ensure labelling happens, I recently cared for a young man with congenital hydrocephalus who is recovering from a severe, life threatening illness that included peritonitis, renal failure and the need for CRRT. This fellow had a VP shunt that was emergently externalized with in hours of admission because he was at extreme risk for ventriculitis. The docs revised his externalized shunt twice, the most recent revision tunnelled it down his back and out through a stab wound on his right side; it then connects to pressure tubing and an EVD setup for collection of CSF. He also has a double lumen right internal mammilary PICC, a right brachial arterial line and a right subclavian hemocath that is no longer in use and so is heparinized with 7500 units per lumen. All of these lines are emerging in virtually the same place. I had not cared for this patient before and was looking for a spot to run his antibiotic that was due right at the beginning of my shift. His externalized shunt tubing looks identical to the silastic portions of his PICC, and it was NOT labeled. Someone in a hurry might have popped a stopcock onto the luer connector and infused 200 Ml of ciprofloxacin into his head. It now sports a large orange warning label, and his hemocath dressing sports another that says, DO NOT USE without removing heparin!!

[spiceyqueen]

we got lots of pretty stickers ( well actually just standard labels) its not policy, but its definitely practice, i do it at the distal end as well, and always trace back at least twise a shift just to be sure,