Who's using pre-spiked fluids? I have trouble with the concept unless the fluid is secured or visible at all times. I work in an ED and have a newer nurse pushing the concept as a "Lean" idea, but it just does not seem safe to me. Joint Commission refers to hospital policy, but we don't really have one. I've done a journal search and haven't come up with much either. What's the consensus and how do explain this? I really wanted some EBP because she doesn't really get how important that is.