Replacement of IV sets when used intermittently

[Maree Sommerville]

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 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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[Tim Spencer]

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, ORiordan 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

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Maree Sommerville
Sent: Monday, 12 November 2012 1:41 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Replacement of IV sets when used intermittently

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

Email: msommerville@mercy.com.au
Phone: 8458 4759

MOB: 0408 789 798
FAX: 8458 4751

_____________________________________________________________________
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DISCLAIMER This email and any files transmitted with it
may be confidential and intended solely for the use of the
individual or entity to whom they are addressed. If you have
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by return email and delete or destroy this message and its
attachments. While this email and any attachments have
been cleared by Mercy Health’s virus protection systems, recipients
should use their own systems to detect computer viruses or other
materials that may corrupt files or systems. Find out more about
Mercy Health at http://www.mercyhealth.com.au

Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of ACIPC.

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_____________________________________________________________________
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Sydney & South Western Sydney Local Health Districts regularly monitor email and attachments to ensure compliance with the NSW Ministry of Health’s Electronic Messaging Policy.

Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of ACIPC.

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[McEwan, Melissa MS]

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

and is subject to the jurisdiction of section 70 of the Crimes Act 1914.
If you have received this email in error, you are requested to contact
the sender and delete the email.

________________________________

Behalf Of Tim Spencer

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

Behalf Of Maree Sommerville

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

_____________________________________________________________________
This email has been scanned for the Sydney & South Western Sydney Local
Health Districts by the MessageLabs Email Security System.
Sydney & South Western Sydney Local Health Districts regularly monitor
email and attachments to ensure compliance with the NSW Ministry of
Health’s Electronic Messaging Policy.

DISCLAIMER This email and any files transmitted with it
may be confidential and intended solely for the use of the
individual or entity to whom they are addressed. If you have
received this email in error please notify the sender immediately
by return email and delete or destroy this message and its
attachments. While this email and any attachments have
been cleared by Mercy Health’s virus protection systems, recipients
should use their own systems to detect computer viruses or other
materials that may corrupt files or systems. Find out more about
Mercy Health at http://www.mercyhealth.com.au

Messages posted to this list are solely the opinion of the authors, and
do not represent the opinion of ACIPC.

Archive of all messages are available at http://aicalist.org.au/archives
– registration and login required.

Replies to this message will be directed back to the list. To create a
new message send an email to aicalist@aicalist.org.au

To send a message to the list administrator send an email to
aicalist-request@aicalist.org.au.

You can unsubscribe from this list be sending ‘signoff aicalist’
(without the quotes) to listserv@aicalist.org.au

_____________________________________________________________________
This email has been scanned for the Sydney & South Western Sydney Local
Health Districts by the MessageLabs Email Security System.
Sydney & South Western Sydney Local Health Districts regularly monitor
email and attachments to ensure compliance with the NSW Ministry of
Health’s Electronic Messaging Policy.
Messages posted to this list are solely the opinion of the authors, and
do not represent the opinion of ACIPC.

Archive of all messages are available at http://aicalist.org.au/archives
– registration and login required.

Replies to this message will be directed back to the list. To create a
new message send an email to aicalist@aicalist.org.au

To send a message to the list administrator send an email to
aicalist-request@aicalist.org.au.

You can unsubscribe from this list be sending ‘signoff aicalist’
(without the quotes) to listserv@aicalist.org.au

Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of ACIPC.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au

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