Nursing assistant reconnected dirty IV line

Editorial Team / Admin · Oct 23, 2015

Did you complete an incident report? That should bring it to the attention of risk management. Also, say something to your manager, who may decide to address it as a unit wide reminder.

Karou · Oct 23, 2015

What did the CNA say when you asked them about it?

In the future you can remind this CNA that you don't want your patients lines disconnected by them, that you want to do it yourself to ensure its done right. Ask them to call you every time they need it done.

AcuteHD · Oct 23, 2015

Dont say nothin' to nobody. A doctor can order antibiotics as needed but is the doctor going to wipe your pts butt after the CNA gets fired? No, you'll be short a CNA that was at least willing to give a bath.

Just kidding. File an incident report.

chevygirl1987 · Oct 23, 2015

I saw a nurse doing this the other day. The other would disconnect his heparin drip to go out and smoke and throw the tubing on the floor. The nurse said if he doesn't care neither do I.

I did an incident report.

IVRUS, BSN, RN · Oct 26, 2015

The nursing assistant working with me in the bay was washing a patient, when I went behind the curtain I saw that she had disconnected the IV line and it was on the floor, uncovered. I went to get a new line to change it, was distracted so it took longer than it should of, when I got back to the patient, the dirty IV line had been reconnected. I removed it and cleaned the port, but I am so worried about the damage that is would have done. Have you ever had an experience like this and how did you deal with it, it is not within the nursing assistant's competency to attach IV lines

I would have immediately exclaimed, " Oh my, the IV tubing is dissconnected, Hold on, I will go get new tubing and fix it." That way you have made your intentions known, and let the CNA off the hook to try and fix something that she made have thought she caused. If she feared that she would get into trouble by the tubing separating from the IV catheter, she may have reconnected, but of course has no knowledge of its ramifications. Now, whatever bacteria that is on the end of the tubing is now traveling inside the patient. Maybe the patient will be able to have his/her immune system to ward off the consequences of this action, but remember that people, especially the elderly have a comprimised immune system and cannot fight infections as they did in their younger years. I would speak to your nursing manager and provide your ancillary help with education of common things, such as this, and what they should, and should NOT do.

Pangea Reunited, ASN, RN · Oct 26, 2015

I would speak to the CNA, directly, and make my expectations and rationales clear. They've probably been encouraged to do it by other staff in the past and may not realize that it's not appropriate. If I spoke to them and the practice continued, then I might have reason to move up the chain of command.

jadelpn, LPN, EMT-B · Oct 26, 2015

It is also an educational opportunity. That CNA's should not be disconnecting IV lines. That is something that they all would have the need to know.

Not to mention the amount of medicine that is leaking out onto the floor due to the pump continuing? And reconnecting an IV in which the extension tubing is dry? Blood in tubing which has clotted and now the IV is unusable?

Yes, gross, on the floor and filthy. But there are a number of other variables. If the CNA is planning on doing bed baths, I would ask them to use IV gowns, I would ask them to advise you when they are ready and you will disconnect the IV to get the regular gown off--but I also would be sure that I immediately reconnected the IV--especially if it is a timed drug.

If you have a CNA (or even an involved family member) who turns off the pump, disconnects the IV, does the bed bath, reconnects the IV, and turns the pump back on, the former information can clear. Which could then be on you.

So this is an important issue that needs to be addressed.

Oh'Ello, BSN, RN · Oct 26, 2015

I wouldn't be so nice. Its not that CNA's "shouldn't" be reconnecting IV's.... it's that it's illegal for them to reconnect IV tubing. CNA's are not licensed to administer IV medications.