Course Access
Hi Melissa
A good example of acronyms being used without reference! 🙂
INS Infusion Nurses Society, and in this case Tim is referring to some guidelines / standards they produce.
http://www.ins1.org
Cheers
Michael
Michael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3326 3523
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
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UNCLASSIFIED
Just wondering what is INS?
Melissa McEwan RN, BN, Grad Cert Infect Control
Quality Manager
Kapooka Health Centre
Contractor to Defence
02 69338338
Private mobile 0428 753783
melissa.mcewan@defence.gov.au
________________________________
INS 2012 Guidelines recommend;
Practice Criteria
III. Primary Intermittent Infusions
A. Primary intermittent administration sets should be changed every 24 hours. When an intermittent infusion is repeatedly disconnected and reconnected for the infusion, there is increased risk of contamination at the catheter hub, needleless connector, and the male luer end of the administration set, potentially increasing risk for catheter-related bloodstream infection. There is an absence of studies addressing administration set changes for intermittent infusions. In a meta-analysis of 12 randomized, controlled trials that supported increasing the time interval for administration set changes to 96 hours, at least 2 of the studies excluded administration sets used for heparin locked catheters and in sets disconnected for more than 4 hours. In several others, exclusions were not stated.1,5 (V)
B. A new, sterile, compatible covering device should be aseptically attached to the end of the administration set after each intermittent use. The practice of attaching the exposed end of the administration set to a port on the same set (“looping”) should be avoided.1,5 (V)
REFERENCES
1. Hadaway L. Infusion therapy equipment. In: Alexander M, Corrigan A, Gorski L, Hankins J, Perucca R, eds. Infusion Nursing: An Evidence-Based Approach. 3rd ed. St Louis, MO: Saunders/Elsevier; 2010:391-436.
2. Gillies D, O’Riordan L, Wallen M, Morrison A, Rankin K, Nagy S. Optimal timing for intravenous administration set replacement. Cochrane Database Syst Rev. 2005;(4):CD003588.
3. Rickard CM, Lipman J, Courtney M, et al. Routine changing of intravenous administration sets does not reduce colonization or infection in central venous catheters. Infect Control Hosp Epidemiol. 2004;25;650-655.
4. Raad I, Hanna HA, Awas A, et al. Optimal changing of intravenous administration sets: is it safe to prolong use beyond 72 hours? Infect Control Hosp Epidemiol. 2001;22(3):136-139.
5. Institute for Safe Medication Practices. Failure to cap IV tubing and disconnect IV ports place patients at risk for infections. Medication Safety Alert! Published July 26, 2007. Accessed June 17, 2010.
Timothy R. Spencer, RN, APN, DipAppSci, Bach.Health, ICCert.
Clinical Nurse Consultant, Central Venous Access & Parenteral Nutrition Service
Conjoint Lecturer, South West Sydney Clinical School | Faculty of Medicine | University of NSW
Dept of Intensive Care, Level 2, Clinical Building, Liverpool Hospital, Elizabeth Street, Liverpool, 2170, NSW, Australia
Tel (+61) 2 8738 3603 | Fax (+61) 2 8738 3551 | Mob +61 (0)409 463 428 | Tim.Spencer@sswahs.nsw.gov.au | Timothy.Spencer@unsw.edu.au
Dear all,
I would be interested in knowing how other organisations manage the issue surrounding the frequency of replacement for IV administration sets when they are used intermittently. The 2011 CDC ‘Guidelines for Prevention of Intravascular Catheter Infections’ mark this as an unresolved issue.
My experience has been that many organisations discard after 24 hours (ritual or evidence based??).
Our packaging is marked with [symbol meaning DO NOT REUSE] indicating it is intended to be used on an individual patient during a single procedure and then discarded.
I would be interested in your views.
Thanks
Maree Sommerville
Infection Control Coordinator
Mercy Hospital for Women
163 Studley Road
Heidelberg, Victoria, 3084
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