Hear, hear.......I agree 100%. Other than I think we would have to say 'we
believe you may be less likely to get an infection if we change your tubing
every day'. There are no absolutes.
Alma Kooistra RN, CRNI
----Original Message Follows----
From: [EMAIL PROTECTED]
To: "Lynn Hadaway" <[EMAIL PROTECTED]>
CC: "Marilyn Hanchett" <[EMAIL PROTECTED]>, [EMAIL PROTECTED],
[EMAIL PROTECTED]
Subject: Re: RE: outpt infusion reusing IV tubing 72hr
Date: Tue, 16 May 2006 22:59:29 -0400
More importantly, I am interested in HOW we could gain such evidence. Do we
expect patients to give informed consent to participate in a study when we
tell them--" this is a study to see if reusing tubing over 72 hours will
cause infections, so we can save $$$ for the hospital, or you can refuse and
we will change your tubing every day, and then we know you will NOT get an
infection"
I find it difficult to imagine how we could come up with such evidence. I
think in some cases we need to use common sense, our assessment skills and
the principals of infection control. Sometimes we need to take what we
already know and apply it to more than one situation.
Chris Cavanaugh, CRNI
Chris Cavanaugh, CRNI
----- Original Message -----
From: Lynn Hadaway <[EMAIL PROTECTED]>
Date: Tuesday, May 16, 2006 1:05 pm
Subject: RE: outpt infusion reusing IV tubing 72hr
To: Marilyn Hanchett <[EMAIL PROTECTED]>, [EMAIL PROTECTED],
[EMAIL PROTECTED]
> 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
>
