Published Oct 9, 2003
My change project involves drawing normal saline flushes from an IV bag thru a one-way valve with a clave cap. Theoretically it would decrease the risk of contaminating the solution and reduce needle injuries, because it uses a luer lock instead of a needle. I am finding some resistance. Has anyone seen this done? Are there any potential problems I should consider?
What are those who resist giving as their rationale?
If it is "but that's not the way we've always done it" -- sorry, but that just doesn't fly.
This is routine in both units I work in.
In PICU, each patient has a separate bag of NS hanging at bedside (250 ml) specifically for flushes drawn via one-way valve - bag is good for 24 hours.
In NICU, where smaller and fewer flushes tend to be given, we have a "unit bag" of NS from which we draw flushes. One 250 ml bag usually lasts 24 hours for the unit.
We have not had any problems with this. The fluids cannot be contaminated as the valve is one-way only.
I agree with you, I have done some research and everything points to it being safe.
I have infection control up in arms because the changing of the bag is not routine and so nurses will forget to change it and that is unsafe. I say, make it a routine.
I have IV therapy saying, "You'll never see that in a hospital." I am glad to hear you have seen it in a hospital.
I think the core problem is that it is a change. This isn't the way they've always done it. If it were good, someone else would have thought of it already. I am just a student! Thanks for your support!
One-way or not, valves can become contaminated; also contamination can occur at other stages of the withdrawal process.
With a very low cost product like saline, I wonder if the prefilled, single use saline syringes now available wouldn't be less subject to contamination, more convenient, and present no potential 24 hour bag limit compliance/documentation problems for minimal additional cost?
Have you investigated this alternative in order to demonstrate that your proposal is equally safe and/or significantly more cost effective?
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