Saline Flushes - My Old As Dirt Question

[Tait, MSN, RN]

Good Morning,

Georgia, about a year ago, I have now heard changed our salines from a medication to a device. TJC supports this as a device. Now comes the process of changing our salines from a scanned med, to a documented part of supplies. Looking for additional points of view on this to present to the task force. It is funny because last week when I Googled for this topic I found my own posts from 2011 where my previous hospital was loosing 1/2 a million a year in unscanned flushes.

Some topics never die.

Thank you for any input you can provide.

[Tait, MSN, RN]

Bumping this for a few more responses. Thank you to everyone who is taking time to fill out the survey.

[registerednutrn, BSN, RN]

If the physician place an order for the flush we scan it if no order we don’t scan but do document an IV flush as part of assessment in EMR. We are trying to get moved from our pharmacy to logistics then won’t be considered a med at all and will not require scanning at all

[Tait, MSN, RN]

26 minutes ago, registerednutrn said:

If the physician place an order for the flush we scan it if no order we don’t scan but do document an IV flush as part of assessment in EMR. We are trying to get moved from our pharmacy to logistics then won’t be considered a med at all and will not require scanning at all

Thanks for this feedback. I will let you know how ours pans out. We meet in two weeks and I am trying to bring back persepctives from other facilities to help support our next steps. At this point it looks like we will be going to charging for flushes as part of "supply". So if you give an IV med you would charge for two flushes automatically (one for pre and post flush). We would have to look at other procedures however, like PICC line blood draws where you may need a lot more. I am pushing for them to stay in the Omnicell for safety and our accreditation folks have confirmed if deemed a medical device they can safely be in a nurses pocket or a locked WOW!, but we still need to keep them out of patients rooms so they can't use it access a line with something we didn't prescribe.

[Swellz]

5 hours ago, registerednutrn said:

If the physician place an order for the flush we scan it if no order we don’t scan but do document an IV flush as part of assessment in EMR.

Same where I work. There is an order for flushes q12 that would require scanning, but it is rarely put in.

[Guest219794]

ER-

Seems like an order automatically enters. It goes on the MAR. I ignore them.

[BlueShoes12, BSN, RN]

When I worked on the floor, flushes were scanned, typically as a q12 hour order. There was the option to scan a PRN flush whenever an IV was given, but only a couple people actually used it. Now, I work in a PACU with paper charting, and we do not document flushes given. Flushes are kept in locked drawers on both units.

[Cloud9RN, BSN]

I always scan saline flushes. It's always in our E-MAR PRN and it will be counted/reflected in the medication intake and output... We kept our saline flushes in the Medroom.

[Tait, MSN, RN]

Thank you so much for all the responses!

[DowntheRiver]

We document our flushes when we flush a port/PICC as part of the procedure.

For IVs, when we d/c the IV we document that we flushed with 10 mL NS.

However, we don't document the flushes we use between meds for IV pushes or the flushes we use to make IV pushes.

[OliveOyl91, BSN, RN]

The only time I scan a flush is when it pops up on the MAR as a scheduled PICC or central line maintenance.

[lregister]

We don’t scan routine Saline flushes. I guess it’s one of the last remaining things us nurses can be trusted to use and not Have to document in 14 places. ?

When we document our IV assessment, we do document that the site flushes.
Heparin flushes are kept in the omnicell and scanned at bedside to patient’s record.