When IV's aren't in use

[Mommy of 2]

Just curious what other nurses do with the end of the IV tubing when the IV's are not in use. Some people hook it to a port on the tubing itself and others just let it hang there....

[kayern]

DO NOT LET IT JUST HANG THERE. Your institution should have dead enders, caps that are intended to keep the system closed. Better yet, if it is not in use, get an order to D/C it, a site that is not being used just leaves the potential for infection.

[Mommy of 2]

I completely agree. When I see the previous nurse just let it hang there. I throw it away and use a new one.

[iluvivt, BSN, RN]

INS has a position on this....NEVER loop it back into a port on the IV tubing. The term "looping" has been coined to describe this unacceptable practice. INS states that is must be capped off with a sterile cap. We had this problem as well and our IV team has stopped it...we ordered the red caps so they would be nice and bright and easy to find..they also have them in blue and white. Those are the colors I have seen out in the IV market place. The sterility of the system can not be guaranteed when tubing is looped and when done the tubing should be considered contaminated. INS also recommends that any primary intermittent tubing be changed every 24 hrs as well b/c when you are frequently connecting and disconnecting the chance for contamination increases greatly.

[classicdame, MSN, EdD]

don't let JC surveyor see it hanging like that. Infection control issue.

[Penelope_Pitstop, BSN, RN]

Better yet, if it is not in use, get an order to D/C it, a site that is not being used just leaves the potential for infection.

This is true; however, at my facility, patients with heart monitors and patients on seizure precautions require IV access at all times.

And then there are patients who only require IV access for antibiotics, SoluMedrol, Lasix, or pain medicine.

[I<3H2O, BSN, RN]

people who loop it and connect it to a port on the tubing make me crazy!! when i walk into a room and see

1. an iv tubing set without a date on it

2. an iv tubing set looped around and connected to itself

3. an iv tubing set without a cap

4. an iv tubing set that is connected to ivf other than normal saline, that is not being used.

5. an iv tubing set that is connected to a daily abx bag

then i immediately throw it in the trash. there are so many nurses that won't take the time to insure that the tubing is appropriately cared for. it makes me crazy!

[iluvivt, BSN, RN]

And here we are trying to achieve a zero IV and CVC related infection rate....HUH! you are correct to be concerned with all the horrible practices I see I am not at all shocked at the horrible things I see every day.

[BonnieSc]

Some questions about this:

--is there a resource online with these guidelines in a simple format?

--these dead-ender caps: are they one-time use?

The hospital I've been in for a year and a half (came as a new grad) always does the looping, and I knew when I saw it that it wasn't anything I'd ever seen in nursing school (I asked in surprise if that was safe, and the nurses looked at me, equally surprised that I would ask, probably wondering if I was competent since I didn't know this "standard practice") but I can't remember now what I did see in nursing school clinicals. I did think it was some kind of cap.

One problem I can see is convenience: nurses where I work aren't really going to do something inconvenient when no one's looking. There are even a few who don't apply needleless caps to the ends of IVs when they saline-lock them--they just put the clamp on and leave the end of the extension tubing open.

Do you all carry these deadenders in your pockets for convenience? I wonder how many I would go through in a day and whether my NM would be okay with me charging a handful to the floor every day (rather than the individual patient). I think we do have something like that in our supply cabinet.

Also, I would be interested in seeing studies about infection caused by this kind of poor IV hygiene. I've seen infected PICCs but not peripherals. I will need data to make changes on my unit.

[solneeshka, BSN, RN]

We're required to have IV access on every patient, all the time. It's generally a really big deal if we lose it and can't get it back.

[solneeshka, BSN, RN]

There are even a few who don't apply needleless caps to the ends of IVs when they saline-lock them--they just put the clamp on and leave the end of the extension tubing open.

Are you KIDDING ME?!?! How can they possibly imagine that they are getting that opening clean/sterile/anything-but-gross before they hook something up to it? Can you imagine if that lock slid off (which can happen pretty easily), how easy it would be for a patient to bleed our or get an air embolus? Nurses who do this are unsafe and should find a different line of work.

We have the red caps, I carry a handful in my pocket every shift, and I go through maybe 5 or 6 of them I guess in a typical shift. Not a big deal. Your nurse manager should be thrilled that you want to use them!

[Do-over, ASN, RN]

We have the blue caps, and I carry several in my pocket. We have a lot of patients that don't have fluid running, just piggybacks, so I use them alot.