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Good morning
Our question is: does anyone have a policy on when to change IV lines that are used for antibiotics and then left to hang disconnected by the patients bed side?
Would love to hear from you if you do.
Wendy Beckingham
CNC Infection Prevention and Control
ph. (02) 6244 3695 or pager 50390
e. wendy.beckingham@act.gov.au
Care Excellence Collaboration Integrity
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Hi,
We don’t have a policy as such but we don’t reconnect any lines once they have been disconnected. When IV fluids have finished, if they in an additive line, the whole thing is thrown away.
IV lines are not disconnected when patients go for showers.
If anything needs to be reconnected, there has to be new giving set and bag of fluids.
We also clean our cannula caps with chlorhexidine alcohol swabs.
Cheers,
Helen.
Helen Scott
Infection Control Co-ordinator &
Acute Pain Service Co-ordinator
Nepean Private Hospital
Penrith, NSW.
0247 327333
Helen.Scott@healthscope.com.auPlease consider the environment before printing this message
>>> On 8/09/2011 at 10:50 am, in message , “Beckingham, Wendy” wrote:
Good morning
Our question is: does anyone have a policy on when to change IV lines that are used for antibiotics and then left to hang disconnected by the patients bed side?
Would love to hear from you if you do.
Wendy Beckingham
CNC Infection Prevention and Control
ph. (02) 6244 3695 or pager 50390
e.wendy.beckingham@act.gov.au ( mailto:fiona.kimber@act.gov.au )
Care Excellence Collaboration Integrity
GERMS CAN KILL…———————————————————————–
This email, and any attachments, may be confidential and also privileged. If you are not the intended recipient, please notify the sender and delete all copies of this transmission along with any attachments immediately. You should not copy or use it for any purpose, nor disclose its contents to any other person.
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I presume you are talking about the minibag and giving set
administration method?
Leaving disconnected IV sets is not great practice – I certainly would
not be encouraging it at all.
Check the CDC guidelines for more definative info also.
INS (USA) guidelines state;
43. ADMINISTRATION SET
CHANGE
Standard
43.1 Administration set changes shall be performed routinely, based on
factors such as type of solution administered, type of the infusion
(continuous versus intermittent), immediately upon suspected
contamination, or when the integrity of the product or system has been
compromised.
43.2 The administration set shall be changed whenever the peripheral
catheter site is rotated or when a new central vascular access device is
placed.
43.3 Add-on devices used as part of the administration set, such as
single- and multilumen extension sets and filters, shall be changed at
the same time as the administration set.
43.4 The frequency of performing administration set changes and the
system used to promote adherence to administration set change (eg,
labeling/electronic) shall be established in organizational policies,
procedures,
and/or practice guidelines.
43.5 A vented administration set shall be used for solutions supplied in
glass or semi-rigid containers, and a nonvented administration set shall
be used for plastic fluid containers.
43.6 All administration sets shall be of luer-lock design to ensure a
secure junction.Practice Criteria
I. General
A. The use of add-on devices for administration sets should be minimized
as each device is a potential source of contamination, misuse, and
disconnection; it is preferable to use an administration set with
devices as an integral part of the set (see Standard 26, Add-on
Devices).1 (V)Practice Criteria
II. Primary and Secondary Continuous Infusions
A. Primary and secondary continuous administration sets used to
administer fluids other than lipid, blood, or blood products should be
changed no more frequently than every 96 hours. There is strong evidence
that changing the administration sets more frequently does not decrease
the risk of infection.2-3 (I)
B. Extending the administration set change to every 7 days may be
considered when an anti-infective central vascular access device (CVAD)
is being used or if fluids that enhance microbial growth are not
administered through the set.3,4 (II)
C. If a secondary administration set is detached from the primary
administration set, the secondary administration set is considered a
primary intermittent administration set and should be changed every 24
hours (see
Practice Criteria III, Primary Intermittent Infusions).1 (V)
D. When compatibility of infusates is verified, use of secondary
administration sets that use back-priming infusion methods are preferred
due to reduced need for disconnecting secondary intermittent
administration sets.1 (V)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
heparinlocked 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)I hope this is usefiul.
Tim Spencer
Clinical Nurse Consultant
Central Venous Access & Parenteral Nutrition Service
Conjoint Lecturer, University of NSW
Department of Intensive Care
Liverpool Hospital
Locked Bag 7103
Liverpool BC NSW 2170
AUSTRALIAPlease note the prefix change in phone/fax numbers
________________________________
Behalf Of Beckingham, Wendy
Good morning
Our question is: does anyone have a policy on when to change IV lines
that are used for antibiotics and then left to hang disconnected by the
patients bed side?Would love to hear from you if you do.
Wendy Beckingham
CNC Infection Prevention and Control
ph. (02) 6244 3695 or pager 50390
e. wendy.beckingham@act.gov.auCare Excellence Collaboration Integrity
GERMS CAN KILL…
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This email, and any attachments, may be confidential and also
privileged. If you are not the intended recipient, please notify the
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nor disclose its contents to any other person.
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Hi Wendy
Here at Wollongong Hospital we support the practice outlined by Helen Scott at the Nepean Hospital.
Another risk factor that needs to be consider when lines are disconnected is the risk of these lines being reconnected to the wrong patient. Although this represents a low risk of blood borne pathogen transmission, it is not now risk, and can lead to unnecessary anxiety for all those involved.
Beth Bint
CNC Infeciton Prevention and Control
The Wollongong Hosptal, NSW________________________________
Good morning
Our question is: does anyone have a policy on when to change IV lines that are used for antibiotics and then left to hang disconnected by the patients bed side?
Would love to hear from you if you do.
Wendy Beckingham
CNC Infection Prevention and Control
ph. (02) 6244 3695 or pager 50390
e. wendy.beckingham@act.gov.au
Care Excellence Collaboration Integrity
GERMS CAN KILL…———————————————————————–
This email, and any attachments, may be confidential and also privileged. If you are not the intended recipient, please notify the sender and delete all copies of this transmission along with any attachments immediately. You should not copy or use it for any purpose, nor disclose its contents to any other person.
———————————————————————–Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of AICA.
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Hi All
We here at Newcastle Private also support the practice outlined by Helen Scott.
My question is..what if the line is not disconnected and remains added into the main line….How often should it be changed?
Should it be every after every antibiotic administration, every 24 hrs, every 72 hrs? This is when the line is an “add a line” and is not disconnected after the antibiotic has run through.
Thanks
Teresa
Teresa Lewis
Infection Control/Prevention
Clinical Nurse Consultant
Newcastle Private Hospital
Email:teresa.lewis@healthscope.com.auPlease consider the environment before printing this message
>>> Beth Bint 18/09/2011 4:12 pm >>>
Hi WendyHere at Wollongong Hospital we support the practice outlined by Helen Scott at the Nepean Hospital.
Another risk factor that needs to be consider when lines are disconnected is the risk of these lines being reconnected to the wrong patient. Although this represents a low risk of blood borne pathogen transmission, it is not now risk, and can lead to unnecessary anxiety for all those involved.
Beth Bint
CNC Infeciton Prevention and Control
The Wollongong Hosptal, NSW________________________________
Good morning
Our question is: does anyone have a policy on when to change IV lines that are used for antibiotics and then left to hang disconnected by the patients bed side?
Would love to hear from you if you do.
Wendy Beckingham
CNC Infection Prevention and Control
ph. (02) 6244 3695 or pager 50390
e. wendy.beckingham@act.gov.au
Care Excellence Collaboration Integrity
GERMS CAN KILL…———————————————————————–
This email, and any attachments, may be confidential and also privileged. If you are not the intended recipient, please notify the sender and delete all copies of this transmission along with any attachments immediately. You should not copy or use it for any purpose, nor disclose its contents to any other person.
———————————————————————–Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of AICA.
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This email, and the files transmitted with it, are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you are not the intended recipient, you are not permitted to distribute or use this email or any of its attachments in any way. We also request that you advise the sender of the incorrect addressing.
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“IMPORTANT – This email contains confidential information intended only for the person named above
and may be subject to legal privilege. If you are not the intended recipient, any disclosure, copying or use
of this information is prohibited. Healthscope provides no guarantee that this communication is free of
virus or that it has not been intercepted or interfered with. If you have received this email in error or have
any other concerns regarding its transmission, please notify Postmaster@healthscope.com.au. You must
destroy the original transmission and its contents. Any views expressed within this communication are
those of the individual sender, except where the sender specifically states them to be the views of
Healthscope. If this document is not required for record keeping purposes please consider the
environment before storing or printing. This communication should not be copied or disseminated without
permission”.Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of AICA.
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