Secondary IV tubing question

[General E. Speaking, RN]

Frequently, I find numerous secondary IV tubings hanging on the pole. One for Levaquin, one for Flagyl, etc..

I was taught (many moons ago) to try and keep the IV set as closed as possible to minimize contamination. I was taught to back flush with the main IV fluid in order to clear the line and then to use the same tubing.

I have emailed our education dept but was wondering what everyone else's policy says?

Thanks

[miss_anneRN]

ok, so say you have two antibiotic piggybacks that are incompatible. when the first one is finished, you back flush the maintence fluid into the empty bag unitl there is just maintance fluid in it. you clamp the secondary tubing, removed the first piggyback bag (that has the back flush), and the hang the second piggyback and unclamp the tubing. the two antibiotics are not mixed, and you use the same tubing with only opening the system to change the bag. the two antibiotics run through the same maintainence tubing, why can't they run through the same piggyback tubing? this is the way i do it. my hospital does not have a policy on it.

:yeahthat:

krisco, (?sp., sorry if not correct:smackingf )

i agree. it seems a waste of product to use multiple lines

queenjean, what's easier is:

1) the tubing of multiple secondary lines can get mixed up. just last week a nurse used multiple lines and didn't sign off a change of shift iv cipro. i checked the pump and it appeared the cipro was attached to the secondary port on the plum cassette because the empty cipro bag was on the front rung of the iv pole and the flagyl (last dose would have 2hrs prior to cipro)was in back. i noticed the po meds for the same time were signed off. the nurse had not mentioned a missed dose or unable to hang in report. i honestly thought i saw the cipro line connected to the cassette. needless to say the cipro dose was missed. i did not note my error until midnight when the next dose of flagyl was due.

risk for contamination: i find myself all thumbs trying to clamp, unscrew from cassette (sometimes not so gracefully!), cap it, move line c empty bag, reach for other line, check the clamp, uncap, screw on, spike bag, oh, yeah, remember to unclamp, set the pump ....

isn't just easier to backprime, remove empty bag, spike new bag, and infuse? my hospital does not have a policy on this either. i would like to find out from a reputable source what's recommened. i just want us all to be on the same page!!!