Possibly, maybe even probably, but I am not aware of any data that
supports this. I don't think a study of this specific question has
been done. That is why this may be appropriate when there are many
intermittent drugs ordered but could be a problem if only one or two
are needed. Lynn
At 1:55 PM -0400 9/15/06, Schwaner, Sandra L *HS wrote:
But, wouldn't running a maintenance solution at 20ml or so an hour,
piggybacking multiple meds into the primary tubing by use of
backflush method, and connecting the entire apparatus , then
disonnecting every 72 hours reduce number of times that the system
is compromised and possible impact infection?
Sandra L. Schwaner MSN, RN, ACNP
P.O. Box 800377
Angiography/ Interventional Radiology
University of Vriginia
Office: 434-924-9401 - 434-243-7081
Fax: 434-982-6468
Pager # 6180
________________________________
From: [EMAIL PROTECTED] on behalf of Lynn Hadaway
Sent: Thu 9/14/2006 6:30 PM
To: Janousek, Patricia; [EMAIL PROTECTED]
Subject: Re: diluents
I am familiar with hospitals that practice this way, although I have
never done it where I have worked. This would not be for the purpose
of actually diluting anything, but it would be used as fluid to keep
the catheter and vein open in between med doses. The issues with
this are:
1. KVO is not a valid order since there is no patient-specific rate
prescribed. So the physicians will need to prescribe a rate.
2. Risk of fluid overload
3. Limitations on patient's ability to get out of bed and ambulate
since they will always be connected to an infusion.
This works best for those patients that are still receiving other
infusions and are not to the point of ambulation.
I also know there are other facilities that will use a bag of
fluids, piggyback all meds into it, and then allow the saline to
infuse after each dose has finished, then the nurse disconnects the
patient after the saline has flushed the line. This is acceptable
and would allow the backpriming procedure to be used for multiple
drugs.
I have recently researched this for one of my manufacturing clients
and there are really no standards about using fluids in this manner.
INS standards do not address it. The other option is to not use this
carrier fluid and infuse each drug directly through the catheter.
This means the nurse must be present to disconnect the tubing
immediately when the med is finished. If not, there will be blood
that refluxes into the lumen leading to a lumen occlusion from
clotted blood. So it is a trade-off for nursing time. Also, using
this carrier fluid connected to the catheter with the backpriming
process for multiple drugs would mean the least amount of catheter
hub manipulation, and thus decrease the risk of catheter related
bloodstream infection. Again, no studies to support that idea either.
Hope this helps, Lynn
At 2:48 PM -0500 9/14/06, Janousek, Patricia wrote:
Hello everyone, I have been asked to check on the practice of
hanging a diluent on a patient who has multiple IVABs scheduled
frequently (Q 4, Q6 hours etc.). I'd like to know if anyone does
this, and if so, is there set criteria, specific solution, rate etc.
Also, are there references I could refer to? INS Standards? Thanks
so much.
Patty
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--
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
