Potential Risks Associated with Contamination in IV Medication Administration

[Manjeet]

I feel bad for something that I can't stop thinking about. Yesterday, a patient came to the clinic for the administration of IV antibiotic cephalexin, 2 grams. He is supposed to receive it every day for the next 10 days for cellulitis. After disconnecting the medication, I flushed the site with NS. Then, I realized there were a few drops left in the piggy bag still, and the patient should receive all the medication. So, I scrubbed the hub where the midline catheter ends and reattached the medication bag. Then, immediately, I realized I forgot that  the bag tubing tip might have touched something because I left it on the chair when I was flushing the site. I should have scrubbed the tip of the bag as well. I feel so guilty. What can my patient get because of this? Today, they discontinued the midline catheter as it was leaking and started a peripheral IV site. What kind of infection can my patient get because of my mistake  Please help."

[jenOK9]

Oh honey, stop.  I am a hundred percent you, 10 years ago, but no more.  What I realized as I saw so many nurses do so many less than best for pts and mistakes I have made, it will be OK.  You will not be perfect, and it will be OK. Will you see this pt again?  That will reassure you.  In my past few positions' things were so sloppy, and the staffing was so bad, I got sloppier, and I am all about doing it the right way.  I am not saying there is never a negative effect, but usually things like this are OK.  You will do it right next time.  Give yourself room to be human.

[Manjeet]

Thank you for your response..yes saw this patient again the next day for antibiotic administration..will see him for next 3 days more..

[ccjennylee]

Totally agree with Jen! I am definitely a worrier and know exactly how you feel. Your pt will be fine. Bonus is they're already getting g+ coverage, and that IV was removed shortly after! And good thing is that's not your usual practice and you'll be even more cautious going forward. It sucks to worry but that means you care and try to do right by your patients. I was in the ED once as a patient (for sepsis, felt like crap), and the nurse didn't scrub anything before connecting and gravity-dripped my vancomycin! I survived! 🙂 

[Been there,done that, ASN, RN]

So what if there were a few drops left. Consider the risk  for contamination with all the futzing after.