The heparin bottle for a cap?

[MAdams2610]

My facility recently hired a new grad RN who attended nursing school in NY. Yesterday, a nurse called me to ask if there were new procedures for heparin administration. She stated that the new grad drew up the heparin and instead of recapping the needle to take into patients room, he left the needle in the heparin vile and used that to walk into the patient's room. He says he was taught that by his clinical instructor.

No one here has ever heard of such a thing, and I can find no literature on it doing a web search. Has anyone ever heard of this?

Thanks...

[Aurora77]

I'm a new grad. We were taught to recap after drawing up meds.

[roser13, ASN, RN]

This is the first I've heard of it as "a practice" but I can see some good points to it. No recapping, therefore no risks of needlestick or contamination.

Plus, it might give the patient the satisfaction of seeing for him/herself what the injection is, in case they're inclined to keep track of what's going into their IV.

[ckh23, BSN, RN]

Never heard of it. It sounds like this was just a way the clinical instructor practiced and passed along to the students.

[Double-Helix, BSN, RN]

Nope, never heard of it. It does not sound like good practice nor safe practice. The needle could break or get bent by the vial. The nurse could get bumped or trip, the needle could come out of the vial and the nurse would be carrying an unsheathed needle. Bad idea.

Perhaps this new grad doesn't understand that it's fine to recap an unused needle. You don't want to recap a needle the has been in the patient because it's a greater risk of a contaminated needle stick. But there is nothing wrong with carefully recapping an unused needle.

[Flo., BSN, RN]

Never heard of that.

[GGT1]

If they are going to use the bottle as a cap...why not just draw it up in the room. Seems like there would be an increased risk of dropping and breaking the bottle, then the needle would be exposed, etc. Just doesn't seem like good practice to me.

[dabears54]

I have seen these things that snap on the top of a vial and it has a plastic "needle" to access the bottle, and then a port at the top (like a heplock for an IV) to attach a syringe to draw up the med, then we'd carry the needle in it's package to the room and attach it at the bedside. We used them on my floor, especially when state was there inspecting since technically you're not supposed to have a syringe of med thats not labeled.

[missbutton]

I'm a newish grad and that's the way I was taught to do it to. 1. As as student we were not to give meds without a nurse verifying the med were were giving/ actually watching us draw the med. 2. It is best to draw the med at the bedside. and 3. It is a huge problem with the joint commission to transport meds in an unlabeled syringe.

Sounds like your new grad is doing a good job.

[Jw1724]

we use those plastic pieces that have a luer lock on one end to attach to the syringe and the plastic "needle" on the other. i DO use these and leave it attached until i am at the bedside. it would be pretty impossible for it to fall out, the plastic piece goes with the bottle to the sharps.

however, heparin.. we have prefilled syringes and just attach a needle. in that situation, id rather draw up at the bedside.

[psu_213, BSN, RN]

I'm a newish grad and that's the way I was taught to do it to. 1. As as student we were not to give meds without a nurse verifying the med were were giving/ actually watching us draw the med. 2. It is best to draw the med at the bedside. and 3. It is a huge problem with the joint commission to transport meds in an unlabeled syringe.

Sounds like your new grad is doing a good job.

But why stick the needle into the vial at all? Why not have the vial, a syringe, and an unopened needle, take all into the room, and draw up there?

[Creamsoda, ASN, RN]

I usually change needles after drawing up. I learned years ago that it hurts less going in that way as heparin wont be all over the outside makeing it burn more. How true that is I dont know. But id rather just recap or draw up in the room