no more NS at chairside!

Published

So state surveyor says that since NS is a medication, and we can't draw up meds chairside, we now have to take a fresh liter bag of NS to the med area, draw up our flushes for CVCs and take-offs, then discard bag of NS (since it is technically single-use.) And they can't be drawn up until after treatment has started since it is only good for 4 hours. This means for every pt that is over 3.5 hours, we will be using 3 bags of NS, instead of the regular 2. Cost, cost, cost. So far we can't get pre-filleds or vials or anything, since this is such a new issue. Apparently my clinic is the first IN THE COUNTRY to have this come up as an issue. We all do it, have done it for years! Why has no one ever had a problem with it before?

So, instead of drawing up the NS from the NS line!(thought that was what it was for) we have to take an extra bag, use it for no more than 40ml of NS, then discard. We start doing this tomorrow, so I have no idea how it will go. Sounds like such a hassle to me!

What do y'all think? And get ready, because it is coming to a clinic near you!

Specializes in Dialysis (acute & chronic).

What would be the difference in sticking a NSS bag multiple times or accessing a fistula needle sticking into a NSS bag multiple times.

In my opinion that is basically the same.

We use prefilled syringes - in the end the cost is the same considering the syringe and needles used and the staff's time to draw them up and label them all. Staff's time needs to be considered in the cost savings too.

Specializes in Dialysis.

We draw from the NS needless port. There are to be no needles chairside, except when giving the Hectorol and Epo.

Specializes in Dialysis.

Will someone please explain to me the rationale behind this new rule. I mean why is it suddenly a no-no to pull saline from the patient's own NS bag? Using ETOH, sterile syringes. We have been doing it this way for years and then suddenly it isn't acceptable. They keep thinking of ways to increase our costs, but do they reimburse us for this? Once we institue pre-filled syringes, they will just come up with some other stupid rule.

Specializes in Dialysis.

i think the CMS thing was that NS was considered a Med, so to draw up a "med" at the chairside is a no-no, thus they were going to make us waste a whole extra bag of NS by drawing it up in our med area. And only one bag per pt, of course! SO 10-20mL of NS from a L bag, then toss it. x 4 patients, x 2 shifts. ridiculous. glad that got thrown out, though. We are back to doing it the old way. Needle-less syringe to draw up our fllushes from the NS port, from the NS bag that is already hanging. No waste there.

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