recapping saline bottles?

[lynswim]

Hi, all - I have just started working in a small hospital OR after being away from the OR for several years. The way staff at my new hospital adds bacitracin to irrigation is to empty the bacitracin powder into a bottle of saline, RECAP, shake the bottle, and pour onto sterile field. I thought we weren't supposed to recap bottles?? I mix powder drugs with saline from a vial and squirt that into saline that's already been poured.

Am I missing something here? Is this the new accepted practice? I don't want to be considered old-fashioned :)

Thanks!

lyn

[Argo]

Sounds not too sterile or clean.... we all reconstitute the baci in the vial with 10cc saline then use syringe and needle to draw up and squirt into the basin on the field.

[Rose_Queen, BSN, MSN, RN]

We either mix in the vial and add to already poured saline (open heart-stronger concentration) or use premixed 3000units/1L bags of baci in saline from pharmacy (everything else).

[NurseLumpia]

Like Argo and Poet...

My OR first pours the saline then asks the scrub to draw up with a syringe and reconstitute the Baci/poly inside its' vial.

Maybe your OR thinks that it's antibiotic anyways and doesn't matter...?

[canesdukegirl, BSN, RN]

NEVER EVER recap a bottle and then deliver it to the sterile field. NO MATTER WHAT. If the policy states that it is acceptable to do this, I would suggest searching through AORN standards to find evidence based practice regarding recapping saline bottles. Then present this to your NM.

Baci should be reconstituted prior to delivery to the sterile field.

[fracturenurse]

Good lord, no! You don't recap the saline bottle. They have developed quite a bad practice there. I do like the above post after it is on the field, I give the scrub a syringe and they give me saline to mix the Baci with. You need to bring them a copy of the AORN standards...

[lynswim]

Thanks for the replies!! I'm glad to know that I was correct in not recapping - but sad that these nurses have been doing this. When I got a vial of NS to mix with the powder, one of the scrubs said, "that's an interesting way to mix it up".

ACK!!

[NurseSnarky]

I'm facing some similar situations.

[Tiffany, RN, BSN]

Luckily our pharmacy pre-mixes our irrigations and we just use a bag decanter to place the mixture onto the field. However after hours etc we draw 10mL out of the bag, mix it in the vial, draw it back up, put it back in the bag, then use a bag decanter to put onto the field.

Recapping a saline bottle is never good aseptic technique.

[shodobe]

Luckily our pharmacy pre-mixes our irrigations and we just use a bag decanter to place the mixture onto the field. However after hours etc we draw 10mL out of the bag, mix it in the vial, draw it back up, put it back in the bag, then use a bag decanter to put onto the field.

Recapping a saline bottle is never good aseptic technique.

I agree about recapping but don't think what the pharmacy is doing is being nice. It is their way of controlling revenue. They can charge more to insurance companies by mixing your meds for you. This is also a way to control the lost revenue by nurses not charging for the mixes they make. I still have a problem with some premix drugs because I don't have control over what is really in the bag. Pharmacists aren't the ones pre-mixing they use IV Techs mostly and can they always be trusted? I really rather mix my own.

[PureLifeRN]

We order our abx irrigation from pharmacy and it comes in a pour bottle with a label on it so I guess they must open it and put the baci/poly in it and then recap it themselves.

[cdsga]

unfortunately, pharmacy is taking over the admixing of medications so much now that the nurses don't know how. Unbelievable but true. Standards of Practice say to use the bottle once and discard. Our pharmacy mixes vials of bacitracin and places them in the pharmacy frig with changed expiration date. We then empty the vial and dilute the med with sterile saline for the back table or draw it from the vial to add to the large bag of saline.