Did not say I agreed with the practice just answering a question that was
posed- playing the devil's advocate so to speak
Ann Marie
----- Original Message -----
Sent: Tuesday, May 16, 2006 2:24 PM
Subject: RE: outpt infusion reusing IV
tubing 72hr
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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