Margaret M Nicastro, CRNI, OCN Coorordinator IV Therapy/Oncology Gettysburg Hospital 147 Gettys Street Gettysburg, PA 17325 Phone: 717-337-4312 Fax: 717-337-4485 Per the new Standards, Site and Care Maintenance, Standard III. Parenteral Nutrition, 48.1 Administration sets for PN are changed every 72 hours and Standard IV, Intravenous Fat Emulsion IVFE, 48.1 Tubings are changed every 24hrs. Our institution follows these standards. We almost always use 3 in 1 PN which includes the lipids in the PN. We have not had to administer separate lipids in about 10 years or more. Occasionally when our physicians order PN without lipids, the next day the patient has 3 in 1 ordered and the tubing is changed every 24hrs anyway. Hope this is helpful,
________________________________ From: [EMAIL PROTECTED] on behalf of Jennifer Kettle Sent: Thu 2/2/2006 11:19 AM To: [EMAIL PROTECTED] Subject: TPN administration setper ts & INT'd tubing changes I have a few questions for the group in which I would so appreciate your input. We are currently looking at policy & procedure at our institution and want to know what everyone else is doing out there in the world. My first question is regarding TPN administration sets. Is anyone using TPN administration sets longer than 24 hours if using extended-life filters? (i.e. if filter is specified as bacterial/ fungal retentive for 96 hours?) Also, when setting up for infusion how do you do so? There is a debate here. Usually, the TPN is set up first with the filter and the lipids are "piggy backed" into the TPN set-up below the filter and proximal to the patient. A debate has arisen as to if this is correct. It is felt by some that the TPN should be piggy backed into the lipids so that when the q 24 hour tubing change of the lipids is done all tubing that had lipids infusing through it would be changed. Theoretically, if the lipids are piggy backed into the TPN as described above then there would be a small amount of tubing that had lipids infusing through it that wouldn't be changed at that time. This is assuming that our theory is correct with TPN admin set changes and the filter being good! for 96 hours. My next question is regarding tubing changes of primary sets when a patient's PIV is INT'd. INS standards suggest that this tubing should be changed every 24 hours. Not sure what the newly released standards suggest. Or, is anyone extending the life of this "primary" tubing for 72-96 hours if the 96 hour filter is in place? Again, thank you for any input that you may have and have a wonderful day. Jenny Kettle, Rn, BSN CONFIDENTIALITY NOTICE: This email may contain confidential health information that is legally privileged. This information is intended for the use of the named recipient(s). The authorized recipient of this information is prohibited from disclosing this information to any party unless required to do so by law or regulation and is required to destroy the information after its stated need has been fulfilled. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of this email is strictly prohibited. If you receive this e-mail message in error, please notify the sender immediately to arrange disposition of the information.
