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Frankly, it just sounds like a mistake
waiting to happen. I wouldn't allow it to be done for me, and would advocate
aggressively for my patients on this one. There may not be evidence (Yet...) to
support changing tubing daily for intermittent infusions- but I would
really want to see the evidence that supports this change in practice before I
implemented it. I think we can all agree that evidence based practice is the
goal -- but in the absence of it, expert opinion is what we have to work
with - and I would choose to
err on the side of caution on something that is relatively low cost and
potentially very high risk.
-----Original
Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]On Behalf Of ann marie
parry
Sent: Tuesday, May 16, 2006 1:27 PM
To:
[EMAIL PROTECTED]; [EMAIL PROTECTED]; [EMAIL PROTECTED];
[EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: Re: outpt infusion
reusing IV tubing 72hr
The answer is as simple as labeling - the tubing should be labeled with
the date and time it is hung and the the patient identifiers (ie name, DOB,
Med Record number) additionally there is labeling on the medication bag it is
attached to.
Ann Marie
----- Original Message -----
Sent: Tuesday, May 16, 2006 1:10
PM
Subject: RE: outpt infusion reusing IV
tubing 72hr
My bigger problem with this whole issue is how you would
absolutely guarantee that the correct tubing was used on the correct patient
when they came back subsequent days. One mistake would cost your
institution so much in a lawsuit that it would negate any savings you hope
to have--not to mention the potential of disease transmission, an allergic
reaction etc. I feel that saving a tubing from day to day is simply a
very bad practice in the outpatient setting regardless of what any standard
would allow you to do.
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]
Behalf Of Lynn Hadaway
Sent: Tuesday, May 16, 2006 8:48 AM
To: Marilyn
Hanchett; [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: RE: outpt
infusion reusing IV tubing 72hr
Then my question to you is - In
the absence of evidence, what do we
use to guide our practice? Is this
just supposed to be a vacuum while
we wait for the science to catch up?
I totally understand the need
for evidence, but you know as well as I do
that many, many nursing
and medical standards and guidelines are written
on nothing less than
the professional opinions of experts. I am not
saying that is ideal,
but I am saying that until we have evidence, this
is the best that we
can do.
I am very curious to know what your
approach would be to any
situation when there are no studies, yet
professional organizations
are expected to provide some guidance on
these issues. Lynn
At 11:26 AM -0400 5/16/06, Marilyn Hanchett
wrote:
>So - once again - we have a "national standard" without
any evidence
>whatsoever to support it. This process, including the
"logic" behind it,
>is an embarrassment to all of us who advocate for
evidence-based
>practice.
>
>Even if you feel compelled to
defend the current (or previous) standards
>documents, this is just
too much. Good grief!
>
>Marilyn Hanchett
RN
>
>
>-----Original Message-----
>From: [EMAIL PROTECTED]
>[mailto:[EMAIL PROTECTED]
On Behalf Of Lynn Hadaway
>Sent: Tuesday, May 16, 2006 9:54
AM
>To: [EMAIL PROTECTED]; [EMAIL PROTECTED]
>Subject: Re: outpt
infusion reusing IV tubing 72hr
>
>This practice would be in
direct conflict with the INS standards of
>practice. This set would be
an intermittent set, therefore it should be
>changed every 24 hours
according to the INS standards of practice.
>CDC guidelines states
this is an unresolved issue. There are absolutely
>no studies that
have looked at the use, change interval or anything
>regarding sets
used for intermittent infusion. This is the reason for
>the INS
standard of changing every 24 hours. You are manipulating both
>ends
of the set frequently. Based on principles of basic infection
>control
and in the absence of any studies, it seems wise to follow
the
>standards. One the other hand, your facility could do a study of
this
>practice and publish your findings which would benefit everyone.
Also,
>the INS standards apply to all settings.
>While primary
and secondary sets should be changed no more frequently
>than 72
hours, INS separates the intermittent sets and this would apply
>to
both inpatient and outpatient settings.
>
>One other thought is
that you would need to have a foolproof method to
>make sure that the
right set gets hooked back to the right patient each
>day. I can
imagine lots of cross-contamination between patients if they
>were to
get mixed up. With busy, understaffed units, I can easily see
>this
happening. Lynn
>
>At 7:50 PM -0400 5/15/06, [EMAIL PROTECTED] wrote:
>>To
reduce cost a suggestion was made to reuse the IV tubing for
72hours
>
>>on a patient that comes in for daily infusion.
The patient would have a
>
>>PICC and come for maybe daily
abx's. The infusion is done the tubing
>>flushed with NS,
disconnected from the PICC and a sterile cap placed
on
>
>>the IV tubing. It is stored in the med room and used
by the same pt for
>
>>3 infusions.
>>We have been
discarding the tubing daily and replacing with new IV
>>tubing
daily.
>>
>>Any support for or against this suggested
practice. P&P is for tubing
>>change 72 hrs but that was
written for inpt
>>
>>Thanks
>>
>>Pat
Dobson
>
>
>--
>Lynn Hadaway, M.Ed., RNC,
CRNI
>Lynn Hadaway Associates, Inc.
>126 Main Street, PO Box
10
>Milner, GA
30257
>http://www.hadawayassociates.com
>office
770-358-7861
--
Lynn Hadaway, M.Ed., RNC, CRNI
Lynn
Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA
30257
http://www.hadawayassociates.com
office
770-358-7861
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