IV protocol
 

Hi, I was just wondering if anyone here can tell me what the IV policies are at the Institution they attend.

My Mum is having intermittent IV antibiotics through a peripheral IV cannula. The nurses keep the same bag of fluid, burette and lines hanging there and connect and disconnect them for each antibiotic. I questioned this procedure and I was told that they can use the same lines and bag for 2 days.

At the Institution where I worked and also the Government Health guidelines covering public health facilities state that new fluid bags and lines have to be used every time a patient has been disconnected and is being reconnected.

I have asked them to use new lines each time or to keep her connected but they are still reconnecting these lines.

Just to complicate things, she has now been isolated due to VRE colonization, fevers of unknown origin and ongoing diarrhea.

I can't get a straight answer from the Infection Control Dept at her facility but it seems as if Government guidelines would prevail even over a private hospital.

Her care in this hospital has been excellent (despite huge communication problems) and this remains my one and only large concern

Regards

Chirley

Hi Chirley,
Whenever the nurses finished with the tubing and bag for a transfusion, fluids, or antibiotics, all of it went right into the bins they have for disposal. They never! reused any of it. Considering these fluids are going right into the bloodstream I would think this is a very prudent thing to do.
I'm glad things seem to have somewhat settled down for you and your parents. You have all been through alot.
God Bless,
Sally

Spiking bags and Tubing
 

Chirley;
Depending on what is being hung is when here in PA you decide to use new tubing. If it is anything filtered - like blood or platelets - new tubing is hung each time. If, however, you get the same med - let's say every 8 hours - they can take down the old bag, clean both ends - the spike and the the end of the new med - and hang it. Tubing can be used for 24 hours, then discarded. I am still amazed at how often the nurses DO NOT intital and date the tubing when it is hung. If I ever went into Earl's room, and it was not initialed and dated - when the next dose was due - I insisted on new tubing - and made sure I knew the nurses name, and time it was done - and I kept a diary - so if any infection happened - I could go back and check.
Good Luck to You.
Beth

Thanks for your answers. A nurse at this hospital told me they re use the same bag and line for two days.

I know for a fact that that is against Government guidelines and I've told them that but they won't do anything about it. I too, am photographing everything just in case she get phlebitis or septicemia.

One more in a long koine of battles.

Regards

Chirley

Thanks for your answers. A nurse at this hospital told me they re use the same bag and line for two days.

I know for a fact that that is against Government guidelines and I've told them that but they won't do anything about it. I too, am photographing everything just in case she get phlebitis or septicemia.

One more in a long line of battles. The problem, of course, is that the run of the mill patient/visitor doesn't know the correct policies and aren't aware that the treatment they are getting is potentially life threatening when it's done incorrectly. If they are lucky and get no complications, they talk about the wonderful care they receive but if they do get a complication, they more often than not, are not told why it happened and think it's just "one of those things".

Regards

Chirley

I just finished reading Unaccountable by Marty Markay MD. He's a surgeon at Johns Hopkins and he echoes your comment Chirley. Basically, most do not know if they got good care or not. There is a transparency issue in our system and we, the public, have very little data to help us make good decisions about our options.

I know Hopkins was very strict on tubing. It was not allowed to touch the ground which meant John was on a short leash from his IV pole. He had two pumps which allowed multiple meds to be infused at the same tim. I think each could handle 8. I don't think they ever let any of the lines hang unconnected. The tubing going from the pump to his lumens, which stayed connected, was changed weekly along with the caps to his hickman.