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CVAD access and flushing

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  • #75087
    Clare Fowler
    Participant

    Author:
    Clare Fowler

    Email:
    clare.fowler2@HEALTH.QLD.GOV.AU

    Organisation:

    State:

    Good morning,
    May I address the brains trust to ask – when accessing CVAD’s in the home environment some staff draw up their flushes in the hospital clinic using no touch technique. They then wrap and carry the flushes to the home to flush and then attach IV A/B’s. Sometimes the drawing up is some hours prior to administration.

    Others take sterile equipment with them ( dressing pack, sterile syringes needles and gloves) and draw up in the home immediately prior to flushing and attaching…
    I can’t find any evidence to tell me if having the Normal Saline sit in the syringe during transport in a car for some hours prior to administration is unsafe i.e. how long is too long for the flush to sit prior to administration…?

    My gut tells me that drawing up as close as possible to administration is ideal – however no evidence available to change clinical practice.

    Any help gratefully appreciated

    Clare Fowler
    Clinical Nurse
    Hospital in the Home, Hervey Bay
    Wide Bay Hospital and Health Service
    p: 07 43256646 | m: 0417013047
    a: Hervey Bay Hospital, Cnr Urraween and Nissen Sts, Hervey Bay, QLD 4655
    e: clare.fowler2@health.qld.gov.au | w: http://www.health.qld.gov.au/widebay

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    #75088
    Marija Juraja
    Participant

    Author:
    Marija Juraja

    Email:
    marija.juraja@sa.gov.au

    Organisation:

    State:

    Good morning,

    I only answered this question yesterday.

    They should be drawing up and dispensing straight away.

    As per NPS

    https://www.nps.org.au/medical-info/medicine-finder/sodium-chloride-0-9-injection

    After being given Sodium Chloride 0.9% Injection

    Storage

    Sodium Chloride 0.9% Injection will be stored in the surgery, pharmacy or ward of a hospital.

    It should be kept in a cool, dry place where the temperature stays below 25C.

    Sodium Chloride 0.9% Injection will only be opened when it is time for you to have the injection.

    It should not be stored after it is opened or used for more than one person.

    Kind Regards

    Marija Juraja |Nurse Unit Manager -CALHN Infection Prevention & Control Unit|
    Division of Acute Medicine (RN, GCNS Inf Ctrl, CICP-E)
    t: +61 8 7074 2810 (RAH) 8222 7588 (TQEH)| M: 0466 379 821|e:marija.juraja@sa.gov.au |
    Adjunct Clinical Lecturer | University of South Australia | Division of Health Sciences
    [Conumers]

    Good morning,
    May I address the brains trust to ask – when accessing CVAD’s in the home environment some staff draw up their flushes in the hospital clinic using no touch technique. They then wrap and carry the flushes to the home to flush and then attach IV A/B’s. Sometimes the drawing up is some hours prior to administration.

    Others take sterile equipment with them ( dressing pack, sterile syringes needles and gloves) and draw up in the home immediately prior to flushing and attaching…
    I can’t find any evidence to tell me if having the Normal Saline sit in the syringe during transport in a car for some hours prior to administration is unsafe i.e. how long is too long for the flush to sit prior to administration…?

    My gut tells me that drawing up as close as possible to administration is ideal – however no evidence available to change clinical practice.

    Any help gratefully appreciated

    Clare Fowler
    Clinical Nurse
    Hospital in the Home, Hervey Bay
    Wide Bay Hospital and Health Service
    p: 07 43256646 | m: 0417013047
    a: Hervey Bay Hospital, Cnr Urraween and Nissen Sts, Hervey Bay, QLD 4655
    e: clare.fowler2@health.qld.gov.au | w: http://www.health.qld.gov.au/widebay

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    #75090
    Anonymous
    Inactive

    Author:
    Anonymous

    Organisation:

    State:

    Hi Clare,
    In another life, I was coordinator of HITH at the Tweed.
    We always did everything in the home at the time of connection using aseptic technique.
    Kind regards
    Kristin

    Kristin Ryan-Agnew
    Kristin Ryan-Agnew (MPH/Grad Cert IP&C)
    Infection Prevention & Control Clinical Nurse Consultant
    The Tweed Hospital

    [cid:image001.png@01D36E89.D6B88C30] National Standard 3 : Preventing and Controlling Healthcare Associated Infections

    [Description: Description: Description: Description: cid:image001.png@01CC899A.70FE88C0]
    I acknowledge the Bundjalung people as traditional owners of the land on which I work and live.
    ‘Bulla Yana Yabur’ Standing Together As One

    Good morning,
    May I address the brains trust to ask – when accessing CVAD’s in the home environment some staff draw up their flushes in the hospital clinic using no touch technique. They then wrap and carry the flushes to the home to flush and then attach IV A/B’s. Sometimes the drawing up is some hours prior to administration.

    Others take sterile equipment with them ( dressing pack, sterile syringes needles and gloves) and draw up in the home immediately prior to flushing and attaching…
    I can’t find any evidence to tell me if having the Normal Saline sit in the syringe during transport in a car for some hours prior to administration is unsafe i.e. how long is too long for the flush to sit prior to administration…?

    My gut tells me that drawing up as close as possible to administration is ideal – however no evidence available to change clinical practice.

    Any help gratefully appreciated

    Clare Fowler
    Clinical Nurse
    Hospital in the Home, Hervey Bay
    Wide Bay Hospital and Health Service
    p: 07 43256646 | m: 0417013047
    a: Hervey Bay Hospital, Cnr Urraween and Nissen Sts, Hervey Bay, QLD 4655
    e: clare.fowler2@health.qld.gov.au | w: http://www.health.qld.gov.au/widebay

    [wbhhs logo]

    [https://encrypted-tbn0.gstatic.com/images?qtbn:ANd9GcSQWOotOf58xTU3bxZ1gVGpeiYdxrPg5BD2tAA3xfYc_zbPsRjeOpqj2w] [linked in, linkedin icon] [Image result for twitter icon] follow us on social media

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    If not an intended recipient of this email, you must not copy, distribute or take any action(s) that relies on it; any form of disclosure, modification, distribution and/or publication of this email is also prohibited.

    Although Queensland Health takes all reasonable steps to ensure this email does not contain malicious software, Queensland Health does not accept responsibility for the consequences if any person’s computer inadvertently suffers any disruption to services, loss of information, harm or is infected with a virus, other malicious computer programme or code that may occur as a consequence of receiving this email.

    Unless stated otherwise, this email represents only the views of the sender and not the views of the Queensland Government.

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    #75091
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Email:
    Michael.Wishart@svha.org.au

    Organisation:

    State:
    NSW

    Hi Clare

    My personal opinion is that this would be an ideal situation for the use of commercial, prefilled saline flush syringes. Would certainly take the uncertainty out of preparing the flush syringes in the home.

    Cheers
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
    T +61 7 3326 3068 | F +61 7 3607 2226
    E michael.wishart@svha.org.au |
    W https://www.svphn.org.au

    [cid:image001.jpg@01D46C86.4CDB6090]
    [2019 conference email signature]

    Good morning,
    May I address the brains trust to ask – when accessing CVAD’s in the home environment some staff draw up their flushes in the hospital clinic using no touch technique. They then wrap and carry the flushes to the home to flush and then attach IV A/B’s. Sometimes the drawing up is some hours prior to administration.

    Others take sterile equipment with them ( dressing pack, sterile syringes needles and gloves) and draw up in the home immediately prior to flushing and attaching…
    I can’t find any evidence to tell me if having the Normal Saline sit in the syringe during transport in a car for some hours prior to administration is unsafe i.e. how long is too long for the flush to sit prior to administration…?

    My gut tells me that drawing up as close as possible to administration is ideal – however no evidence available to change clinical practice.

    Any help gratefully appreciated

    Clare Fowler
    Clinical Nurse
    Hospital in the Home, Hervey Bay
    Wide Bay Hospital and Health Service
    p: 07 43256646 | m: 0417013047
    a: Hervey Bay Hospital, Cnr Urraween and Nissen Sts, Hervey Bay, QLD 4655
    e: clare.fowler2@health.qld.gov.au | w: https://clicktime.symantec.com/38NAFC4KcZZizXjvuG8acg7Vc?uwww.health.qld.gov.au%2Fwidebay

    [wbhhs logo]

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    If you are not the intended recipient(s), or if you have received this email in error, you are asked to immediately notify the sender by telephone collect on Australia +61 1800 198 175 or by return email. You should also delete this email, and any copies, from your computer system network and destroy any hard copies produced.

    If not an intended recipient of this email, you must not copy, distribute or take any action(s) that relies on it; any form of disclosure, modification, distribution and/or publication of this email is also prohibited.

    Although Queensland Health takes all reasonable steps to ensure this email does not contain malicious software, Queensland Health does not accept responsibility for the consequences if any person’s computer inadvertently suffers any disruption to services, loss of information, harm or is infected with a virus, other malicious computer programme or code that may occur as a consequence of receiving this email.

    Unless stated otherwise, this email represents only the views of the sender and not the views of the Queensland Government.

    **********************************************************************************

    ______________________________________________________________________
    This email and any attachments to it (the “Email”) is confidential and is for the use only of the intended recipient, and may not be duplicated or used by any other party without the express consent of the sender. If you are not the intended recipient of the Email, please notify the sender immediately by return https://clicktime.symantec.com/3KVwFJb6MgaYp4Bq3EJSDE87Vc?uemail%2C%20delete%20the%20Email%2C%20and%20do not copy, print, retransmit, store or act in reliance on the Email. St Vincent’s Health Australia (“SVHA”) does not guarantee that the Email is free from errors, viruses or interference. Emails to and from SVHA or its related entities may be scanned and filtered in locations outside Australia.
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    #75097
    Sheryl Perry
    Participant

    Author:
    Sheryl Perry

    Email:
    shezpez@OUTLOOK.COM

    Organisation:

    State:

    They must use 10 ml syringes and draw up as the caliber is different to pre filled syringes. Pre filled syringes are not recommended for CVAD s . They should be drawing up at the time of commencing a flush

    Sent from my iPhone

    On 15 Feb 2019, at 8:23 am, Elizabeth A. Reading <Liz.Reading@hnehealth.nsw.gov.au> wrote:

    Hi Clare,

    Yes, I agree with Michael.
    We use the pre-filled syringes too.

    Cheers
    Liz

    Liz Reading

    Clinical Nurse Consultant | Infection Prevention Service
    Lower Mid North Coast Sector, HNELHD
    C/o Manning Base Hospital, 26 York Street, TAREE, NSW, 2430
    Tel 02 6592 9351 | Mob 0427 777 612 | liz.reading@hnehealth.nsw.gov.au
    http://www.health.nsw.gov.au

    From: ACIPC Infexion Connexion [mailto:ACIPCLIST@ACIPC.ORG.AU] On Behalf Of Michael Wishart
    Sent: Tuesday, 12 February 2019 2:25 PM
    To: ACIPCLIST@ACIPC.ORG.AU
    Subject: Re: [ACIPC_Infexion_Connexion] CVAD access and flushing

    Hi Clare

    My personal opinion is that this would be an ideal situation for the use of commercial, prefilled saline flush syringes. Would certainly take the uncertainty out of preparing the flush syringes in the home.

    Cheers
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
    T +61 7 3326 3068 | F +61 7 3607 2226
    E michael.wishart@svha.org.au |
    W https://www.svphn.org.au

    [cid:image001.jpg@01D46C86.4CDB6090]
    [2019 conference email signature]

    From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> On Behalf Of Clare Fowler
    Sent: Tuesday, 12 February 2019 10:36 AM
    To: ACIPCLIST@ACIPC.ORG.AU
    Subject: CVAD access and flushing

    Good morning,
    May I address the brains trust to ask when accessing CVADs in the home environment some staff draw up their flushes in the hospital clinic using no touch technique. They then wrap and carry the flushes to the home to flush and then attach IV A/Bs. Sometimes the drawing up is some hours prior to administration.

    Others take sterile equipment with them ( dressing pack, sterile syringes needles and gloves) and draw up in the home immediately prior to flushing and attaching
    I cant find any evidence to tell me if having the Normal Saline sit in the syringe during transport in a car for some hours prior to administration is unsafe i.e. how long is too long for the flush to sit prior to administration?

    My gut tells me that drawing up as close as possible to administration is ideal however no evidence available to change clinical practice.

    Any help gratefully appreciated

    Clare Fowler
    Clinical Nurse
    Hospital in the Home, Hervey Bay
    Wide Bay Hospital and Health Service
    p: 07 43256646 | m: 0417013047
    a: Hervey Bay Hospital, Cnr Urraween and Nissen Sts, Hervey Bay, QLD 4655
    e: clare.fowler2@health.qld.gov.au | w: https://clicktime.symantec.com/38NAFC4KcZZizXjvuG8acg7Vc?u=www.health.qld.gov.au%2Fwidebay

    [wbhhs logo]

    [https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcSQWOotOf58xTU3bxZ1gVGpeiYdxrPg5BD2tAA3xfYc_zbPsRjeOpqj2w] [linked in, linkedin icon] [Image result for twitter icon] follow us on social media

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    If you are not the intended recipient(s), or if you have received this email in error, you are asked to immediately notify the sender by telephone collect on Australia +61 1800 198 175 or by return email. You should also delete this email, and any copies, from your computer system network and destroy any hard copies produced.

    If not an intended recipient of this email, you must not copy, distribute or take any action(s) that relies on it; any form of disclosure, modification, distribution and/or publication of this email is also prohibited.

    Although Queensland Health takes all reasonable steps to ensure this email does not contain malicious software, Queensland Health does not accept responsibility for the consequences if any person’s computer inadvertently suffers any disruption to services, loss of information, harm or is infected with a virus, other malicious computer programme or code that may occur as a consequence of receiving this email.

    Unless stated otherwise, this email represents only the views of the sender and not the views of the Queensland Government.

    **********************************************************************************

    ______________________________________________________________________
    This email and any attachments to it (the “Email”) is confidential and is for the use only of the intended recipient, and may not be duplicated or used by any other party without the express consent of the sender. If you are not the intended recipient of the Email, please notify the sender immediately by return https://clicktime.symantec.com/3KVwFJb6MgaYp4Bq3EJSDE87Vc?u=email%2C%20delete%20the%20Email%2C%20and%20do not copy, print, retransmit, store or act in reliance on the Email. St Vincent’s Health Australia (“SVHA”) does not guarantee that the Email is free from errors, viruses or interference. Emails to and from SVHA or its related entities may be scanned and filtered in locations outside Australia.
    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

    The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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    #75098
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Email:
    Michael.Wishart@svha.org.au

    Organisation:

    State:
    NSW

    Hi Sheryl

    We use 10ml pre-filled saline syringes for all CVAD flushing, and for peripheral device flushes as well.

    It was just easier to have one pre-filled saline syringe size. We dont stock any pre-filled saline syringes smaller than 10 ml.

    Cheers
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
    T +61 7 3326 3068 | F +61 7 3607 2226
    E michael.wishart@svha.org.au |
    W https://www.svphn.org.au

    [cid:image001.jpg@01D46C86.4CDB6090]
    [2019 conference email signature]

    From: ACIPC Infexion Connexion On Behalf Of Sheryl Perry
    Sent: Friday, 15 February 2019 8:49 AM
    To: ACIPCLIST@ACIPC.ORG.AU
    Subject: Re: CVAD access and flushing

    They must use 10 ml syringes and draw up as the caliber is different to pre filled syringes. Pre filled syringes are not recommended for CVAD s . They should be drawing up at the time of commencing a flush
    Sent from my iPhone

    On 15 Feb 2019, at 8:23 am, Elizabeth A. Reading <Liz.Reading@hnehealth.nsw.gov.au> wrote:
    Hi Clare,

    Yes, I agree with Michael.
    We use the pre-filled syringes too.

    Cheers
    Liz

    Liz Reading

    Clinical Nurse Consultant | Infection Prevention Service
    Lower Mid North Coast Sector, HNELHD
    C/o Manning Base Hospital, 26 York Street, TAREE, NSW, 2430
    Tel 02 6592 9351 | Mob 0427 777 612 | liz.reading@hnehealth.nsw.gov.au
    http://www.health.nsw.gov.au

    From: ACIPC Infexion Connexion [mailto:ACIPCLIST@ACIPC.ORG.AU] On Behalf Of Michael Wishart
    Sent: Tuesday, 12 February 2019 2:25 PM
    To: ACIPCLIST@ACIPC.ORG.AU
    Subject: Re: [ACIPC_Infexion_Connexion] CVAD access and flushing

    Hi Clare

    My personal opinion is that this would be an ideal situation for the use of commercial, prefilled saline flush syringes. Would certainly take the uncertainty out of preparing the flush syringes in the home.

    Cheers
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
    T +61 7 3326 3068 | F +61 7 3607 2226
    E michael.wishart@svha.org.au |
    W https://www.svphn.org.au

    [cid:image001.jpg@01D46C86.4CDB6090]
    [2019 conference email signature]

    From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> On Behalf Of Clare Fowler
    Sent: Tuesday, 12 February 2019 10:36 AM
    To: ACIPCLIST@ACIPC.ORG.AU
    Subject: CVAD access and flushing

    Good morning,
    May I address the brains trust to ask when accessing CVADs in the home environment some staff draw up their flushes in the hospital clinic using no touch technique. They then wrap and carry the flushes to the home to flush and then attach IV A/Bs. Sometimes the drawing up is some hours prior to administration.

    Others take sterile equipment with them ( dressing pack, sterile syringes needles and gloves) and draw up in the home immediately prior to flushing and attaching
    I cant find any evidence to tell me if having the Normal Saline sit in the syringe during transport in a car for some hours prior to administration is unsafe i.e. how long is too long for the flush to sit prior to administration?

    My gut tells me that drawing up as close as possible to administration is ideal however no evidence available to change clinical practice.

    Any help gratefully appreciated

    Clare Fowler
    Clinical Nurse
    Hospital in the Home, Hervey Bay
    Wide Bay Hospital and Health Service
    p: 07 43256646 | m: 0417013047
    a: Hervey Bay Hospital, Cnr Urraween and Nissen Sts, Hervey Bay, QLD 4655
    e: clare.fowler2@health.qld.gov.au | w: https://clicktime.symantec.com/38NAFC4KcZZizXjvuG8acg7Vc?u=www.health.qld.gov.au%2Fwidebay

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    #75113
    marjenes@OPTUSNET.COM.AU Subject: Re: CVAD access and flushing In-Reply-To:
    Participant

    Author:
    marjenes@OPTUSNET.COM.AU Subject: Re: CVAD access and flushing In-Reply-To:

    Email:
    ef2dee0af08246558954cf8957c189b8@HNEPMBX-MEX002.hneahs.nswhe

    Organisation:

    State:

    Sat

    Dear Claire – the environment for drawing up a syringe for later use i.e.
    some hours later would need to be the standard used when making
    pharmaceuticals (a clean room) i.e the same conditions that the prefilled
    commercially avail syringes come in. As this is not possible in the first
    scenario you mention, I would not be prefilling. In terms of evidence – a
    trial to see whether the two are equal in preventing infection would be
    unethical but I would suggest there would be evidence that this method in an
    uncontrolled environment allows for the entry to and growth of, bacteria in
    the syringe. In the delay of some hours and with an uncontrolled
    temperature, some bacteria may multiply each half hour.

    Regards,

    Margaret Jennings
    Marjen Education Services

    website. http://www.marjenes.com.au
    email. marjenes@optusnet.com.au

    mob. 0404 088 754
    fax. 03 9439 2436

    Elizabeth A. Reading

    Hi Clare,

    Yes, I agree with Michael.

    We use the pre-filled syringes too.

    Cheers

    Liz

    Liz Reading

    Clinical Nurse Consultant | Infection Prevention Service

    Lower Mid North Coast Sector, HNELHD
    C/o Manning Base Hospital, 26 York Street, TAREE, NSW, 2430
    Tel 02 6592 9351 | Mob 0427 777 612 |
    liz.reading@hnehealth.nsw.gov.au
    http://www.health.nsw.gov.au

    Michael Wishart

    Hi Clare

    My personal opinion is that this would be an ideal situation for the use of
    commercial, prefilled saline flush syringes. Would certainly take the
    uncertainty out of preparing the flush syringes in the home.

    Cheers

    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032

    T +61 7 3326 3068 | F +61 7 3607 2226

    E michael.wishart@svha.org.au |

    W https://www.svphn.org.au

    > On Behalf Of Clare Fowler

    Good morning,

    May I address the brains trust to ask – when accessing CVAD’s in the home
    environment some staff draw up their flushes in the hospital clinic using no
    touch technique. They then wrap and carry the flushes to the home to flush
    and then attach IV A/B’s. Sometimes the drawing up is some hours prior to
    administration.

    Others take sterile equipment with them ( dressing pack, sterile syringes
    needles and gloves) and draw up in the home immediately prior to flushing
    and attaching.

    I can’t find any evidence to tell me if having the Normal Saline sit in the
    syringe during transport in a car for some hours prior to administration is
    unsafe i.e. how long is too long for the flush to sit prior to
    administration.?

    My gut tells me that drawing up as close as possible to administration is
    ideal – however no evidence available to change clinical practice.

    Any help gratefully appreciated

    Clare Fowler
    Clinical Nurse
    Hospital in the Home, Hervey Bay
    Wide Bay Hospital and Health Service
    p: 07 43256646 | m: 0417013047
    a: Hervey Bay Hospital, Cnr Urraween and Nissen Sts, Hervey Bay, QLD 4655
    e: c
    lare.fowler2@health.qld.gov.au | w:
    https://clicktime.symantec.com/38NAFC4KcZZizXjvuG8acg7Vc?u=www.health.qld.go
    v.au%2Fwidebay

    follow us on social media

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    Any unauthorised use, alteration, disclosure, distribution or review of this
    email is strictly prohibited. The information contained in this email,
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    confidentiality if it relates to health service matters.

    If you are not the intended recipient(s), or if you have received this email
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    collect on Australia +61 1800 198 175 or by return email. You should also
    delete this email, and any copies, from your computer system network and
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    #75117
    Tina Muller
    Participant

    Author:
    Tina Muller

    Email:
    Tina.Muller@HEALTH.QLD.GOV.AU

    Organisation:

    State:

    Hi Claire,
    We use pre-filled syringes.
    Convenience, cost effective.

    Regards,
    Tina

    Tina Muller
    CNC, Theatre & CSD
    Mackay Base Hospital
    MHHS

    Sat
    Dear Claire – the environment for drawing up a syringe for later use i.e. some hours later would need to be the standard used when making pharmaceuticals (a clean room) i.e the same conditions that the prefilled commercially avail syringes come in. As this is not possible in the first scenario you mention, I would not be prefilling. In terms of evidence – a trial to see whether the two are equal in preventing infection would be unethical but I would suggest there would be evidence that this method in an uncontrolled environment allows for the entry to and growth of, bacteria in the syringe. In the delay of some hours and with an uncontrolled temperature, some bacteria may multiply each half hour.

    Regards,

    Margaret Jennings
    Marjen Education Services

    website. http://www.marjenes.com.au
    email. marjenes@optusnet.com.au

    mob. 0404 088 754
    fax. 03 9439 2436

    Hi Clare,

    Yes, I agree with Michael.
    We use the pre-filled syringes too.

    Cheers
    Liz

    Liz Reading

    Clinical Nurse Consultant | Infection Prevention Service
    Lower Mid North Coast Sector, HNELHD
    C/o Manning Base Hospital, 26 York Street, TAREE, NSW, 2430
    Tel 02 6592 9351 | Mob 0427 777 612 | liz.reading@hnehealth.nsw.gov.au
    http://www.health.nsw.gov.au

    Hi Clare

    My personal opinion is that this would be an ideal situation for the use of commercial, prefilled saline flush syringes. Would certainly take the uncertainty out of preparing the flush syringes in the home.

    Cheers
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
    T +61 7 3326 3068 | F +61 7 3607 2226
    E michael.wishart@svha.org.au |
    W https://www.svphn.org.au

    [cid:image001.jpg@01D46C86.4CDB6090]
    [2019 conference email signature]

    Good morning,
    May I address the brains trust to ask – when accessing CVAD’s in the home environment some staff draw up their flushes in the hospital clinic using no touch technique. They then wrap and carry the flushes to the home to flush and then attach IV A/B’s. Sometimes the drawing up is some hours prior to administration.

    Others take sterile equipment with them ( dressing pack, sterile syringes needles and gloves) and draw up in the home immediately prior to flushing and attaching…
    I can’t find any evidence to tell me if having the Normal Saline sit in the syringe during transport in a car for some hours prior to administration is unsafe i.e. how long is too long for the flush to sit prior to administration…?

    My gut tells me that drawing up as close as possible to administration is ideal – however no evidence available to change clinical practice.

    Any help gratefully appreciated

    Clare Fowler
    Clinical Nurse
    Hospital in the Home, Hervey Bay
    Wide Bay Hospital and Health Service
    p: 07 43256646 | m: 0417013047
    a: Hervey Bay Hospital, Cnr Urraween and Nissen Sts, Hervey Bay, QLD 4655
    e: clare.fowler2@health.qld.gov.au | w: https://clicktime.symantec.com/38NAFC4KcZZizXjvuG8acg7Vc?uwww.health.qld.gov.au%2Fwidebay

    [wbhhs logo]

    [https://encrypted-tbn0.gstatic.com/images?qtbn:ANd9GcSQWOotOf58xTU3bxZ1gVGpeiYdxrPg5BD2tAA3xfYc_zbPsRjeOpqj2w] [linked in, linkedin icon] [Image result for twitter icon] follow us on social media

    ********************************************************************************

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    Any unauthorised use, alteration, disclosure, distribution or review of this email is strictly prohibited. The information contained in this email, including any attachment sent with it, may be subject to a statutory duty of confidentiality if it relates to health service matters.

    If you are not the intended recipient(s), or if you have received this email in error, you are asked to immediately notify the sender by telephone collect on Australia +61 1800 198 175 or by return email. You should also delete this email, and any copies, from your computer system network and destroy any hard copies produced.

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    #75123
    Clare Fowler
    Participant

    Author:
    Clare Fowler

    Email:
    clare.fowler2@HEALTH.QLD.GOV.AU

    Organisation:

    State:

    Thank you for your reply.
    Yes I agree. And as I understand the prefilled cannot be used on a sterile field and my practice is to always open a sterile field at the home ( as variable conditions apply as you would imagine!) and draw up on the sterile field immediately prior to administration.

    Much appreciated

    Clare

    From: ACIPC Infexion Connexion [mailto:ACIPCLIST@ACIPC.ORG.AU] On Behalf Of Sheryl Perry
    Sent: Friday, 15 February 2019 8:49 AM
    To: ACIPCLIST@ACIPC.ORG.AU
    Subject: Re: CVAD access and flushing

    They must use 10 ml syringes and draw up as the caliber is different to pre filled syringes. Pre filled syringes are not recommended for CVAD s . They should be drawing up at the time of commencing a flush
    Sent from my iPhone

    On 15 Feb 2019, at 8:23 am, Elizabeth A. Reading <Liz.Reading@hnehealth.nsw.gov.au> wrote:
    Hi Clare,

    Yes, I agree with Michael.
    We use the pre-filled syringes too.

    Cheers
    Liz

    Liz Reading

    Clinical Nurse Consultant | Infection Prevention Service
    Lower Mid North Coast Sector, HNELHD
    C/o Manning Base Hospital, 26 York Street, TAREE, NSW, 2430
    Tel 02 6592 9351 | Mob 0427 777 612 | liz.reading@hnehealth.nsw.gov.au
    http://www.health.nsw.gov.au

    From: ACIPC Infexion Connexion [mailto:ACIPCLIST@ACIPC.ORG.AU] On Behalf Of Michael Wishart
    Sent: Tuesday, 12 February 2019 2:25 PM
    To: ACIPCLIST@ACIPC.ORG.AU
    Subject: Re: [ACIPC_Infexion_Connexion] CVAD access and flushing

    Hi Clare

    My personal opinion is that this would be an ideal situation for the use of commercial, prefilled saline flush syringes. Would certainly take the uncertainty out of preparing the flush syringes in the home.

    Cheers
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
    T +61 7 3326 3068 | F +61 7 3607 2226
    E michael.wishart@svha.org.au |
    W https://www.svphn.org.au

    [cid:image001.jpg@01D46C86.4CDB6090]
    [2019 conference email signature]

    From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> On Behalf Of Clare Fowler
    Sent: Tuesday, 12 February 2019 10:36 AM
    To: ACIPCLIST@ACIPC.ORG.AU
    Subject: CVAD access and flushing

    Good morning,
    May I address the brains trust to ask when accessing CVADs in the home environment some staff draw up their flushes in the hospital clinic using no touch technique. They then wrap and carry the flushes to the home to flush and then attach IV A/Bs. Sometimes the drawing up is some hours prior to administration.

    Others take sterile equipment with them ( dressing pack, sterile syringes needles and gloves) and draw up in the home immediately prior to flushing and attaching
    I cant find any evidence to tell me if having the Normal Saline sit in the syringe during transport in a car for some hours prior to administration is unsafe i.e. how long is too long for the flush to sit prior to administration?

    My gut tells me that drawing up as close as possible to administration is ideal however no evidence available to change clinical practice.

    Any help gratefully appreciated

    Clare Fowler
    Clinical Nurse
    Hospital in the Home, Hervey Bay
    Wide Bay Hospital and Health Service
    p: 07 43256646 | m: 0417013047
    a: Hervey Bay Hospital, Cnr Urraween and Nissen Sts, Hervey Bay, QLD 4655
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