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  • #68735
    Beckingham, Wendy
    Participant

    Author:
    Beckingham, Wendy

    Email:
    Wendy.Beckingham@ACT.GOV.AU

    Organisation:

    State:

    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…

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    #68736
    Claire Rickard
    Participant

    Author:
    Claire Rickard

    Email:
    c.rickard@GRIFFITH.EDU.AU

    Organisation:

    State:

    #68740
    Helen Scott
    Participant

    Author:
    Helen Scott

    Email:
    Helen.Scott@HEALTHSCOPE.COM.AU

    Organisation:

    State:

    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.au

    Please 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…

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    #68742
    Tim Spencer
    Participant

    Author:
    Tim Spencer

    Email:
    Tim.Spencer@SSWAHS.NSW.GOV.AU

    Organisation:

    State:

    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
    AUSTRALIA

    Please 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.au

    Care Excellence Collaboration Integrity

    GERMS CAN KILL…

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    #68750
    Beth Bint
    Participant

    Author:
    Beth Bint

    Email:
    Beth.Bint@SESIAHS.HEALTH.NSW.GOV.AU

    Organisation:

    State:

    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.
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    #68751
    Teresa Lewis
    Participant

    Author:
    Teresa Lewis

    Email:
    Teresa.Lewis@HEALTHSCOPE.COM.AU

    Organisation:

    State:

    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.au

    Please consider the environment before printing this message

    >>> Beth Bint 18/09/2011 4:12 pm >>>
    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.
    ———————————————————————–

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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.

    This email message has been virus-scanned. Although no computer viruses were detected, Illawarra Shoalhaven Local Health District, South East Sydney Local Health District and Sydney Children’s Hospital Network (Randwick Campus) accept no liability for any consequential damage resulting from email containing any computer viruses.

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