[Ruth L Barratt]

Hi there,
The Infusion Nurses Society Standards 2016 state this which may be helpful
but not very specific:
‘Avoid disconnecting primary continuous administration sets from the VAD
hub or access site. (V, Committee Consensus)’ (page S84)
and
III. Primary Intermittent Infusions
A. Change intermittent administration sets every 24 hours. When an
intermittent infusion is repeatedly disconnected and reconnected for the
infusion, there is increased risk of contamination at the spike end,
catheter hub, needleless connector, and the male luer end of the
administration set, potentially increasing risk for catheter-related
bloodstream infection (CR-BSI). There is an absence of studies addressing
administration set changes for intermittent infusions. 10 (V, Committee
Consensus)
B. Aseptically attach a new, sterile, compatible covering device to the
male luer end of the administration set after each intermittent use. Do not
attach the exposed male luer end of the administration set to a port on the
same set (looping). 3,12 (V)

Ruth Barratt
Infection Prevention & Control Advisor

On Thu, Feb 22, 2018 at 9:33 AM, Mary Wyer wrote:

> I can’t offer any existing guidelines – but here are a few other things to
> consider if you are developing one.
>
> – Staff I see often disconnect an IV and “cap” it onto the side port –
> usually with no alcohol swabbing of the side port.
> – Patients also often request to have IVs disconnected (for showers
> and walks) and don’t understand why the nurse yesterday did and you won’t.
> We need to talk with patients & visitors a lot more about why this is not
> good for them.
>
>
>
> *Mary Wyer*
>
> *ORCID ID*: orcid.org/0000-0002-1215-8089
> *Alumni Foundation Brocher:* http://www.brocher.ch/en
> *Twitter: *@mary_wyer
>
>
>
> On Wed, Feb 21, 2018 at 12:41 PM, Michael Wishart Michael.Wishart@svha.org.au> wrote:
>
>> Hi Helen
>>
>>
>>
>> We have this statement in our IV infusion care policy:
>>
>>
>>
>> Intermittent disconnection of administration sets used for continuous
>> infusions, is not recommended due to the increased risk of infection
>> through manipulation of the hub and occlusion due to reflux of blood into
>> the cannula tip when the line is disconnected; Intermittent administration
>> sets should be discarded after each use if disconnected
>>
>>
>>
>> This is based on the QLD iCARE guidelines (https://www.health.qld.gov.au
>> /__data/assets/pdf_file/0025/444490/icare-pivc-guideline.pdf ).
>>
>>
>>
>> Hope this helps.
>>
>>
>>
>> Cheers
>>
>> Michael
>>
>>
>>
>>
>>
>> *Michael Wishart, *CICP-E
>>
>> Infection Control Coordinator
>>
>>
>> *A *627 Rode Road, Chermside QLD 4032
>>
>> *P *(07) 3326 3068 | *F *(07) 3607 2226 | *E *
>> michael.wishart@svha.org.au | *W * http://www.hsnph.org.au
>> [image: cid:image001.png@01D01926.61F1C2B0]
>>
>> P *Please consider the environment before printing this email *
>>
>>
>>
>>
>>
>> *From:* ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] *On
>> Behalf Of *Helen Scott
>> *Sent:* Wednesday, 21 February 2018 11:31 AM
>> *To:* AICALIST@AICALIST.ORG.AU
>> *Subject:* [ACIPC_Infexion_Connexion] Discouraging disconnection of IV
>> fluids for showering patients ad going to X-ray etc.
>>
>>
>>
>> Hi all,
>>
>>
>>
>> Does anyone have any evidence or best practice guidelines for the above
>> please?
>>
>> Where I am currently working, this happens all the time, both with PIVCs
>> and CVADs (rather worrisome).
>>
>> Sometimes these giving sets are hanging around, disconnected for several
>> hours. And theres the risk of them being forgotten.
>>
>> But the biggest problem is the staff capping the end and thinking this is
>> ok. Im not seeing good hand hygiene for a start but surely theres a risk
>> of contamination once the giving set is disconnected from the the cannula?
>> And does anyone have anything around how long IV fluids can sit in the
>> giving set for once disconnected?
>>
>> I have found a guideline from 2009 from the Royal Hospital for Women, but
>> its not quite specific enough.
>>
>>
>>
>> Thanks in advance,
>>
>> Helen Scott, ICP.
>>
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