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4 posts / 0 new

Fri, 01/18/2013 - 20:00

Elizabeth Defina

How long to put infusions on hold for lab draws??

We have a policy that we stop all infuions that are not titrated medications for 1 minuite prior to drawing a discard and labs from a central line. I now read in a phlebotomy book that infusions should be on hold for 3 minutes. How long do other institutions put their lines on hold prior to draws?

Mon, 01/21/2013 - 17:09

lynncrni

I am not aware of any

I am not aware of any evidence to support a specific length of time. What is the reference used in this textbook for 3 minutes? If they have no reference, then I would infer that it is a professional opinion and not an evidence-based recommendation. I would worry about blood reflux and the beginning of partial obstruction with the 3 minutes. Of course, the overall practice now is to avoid use of all CVADs for blood sampling due to the increased risk of contamination from the excessive manipulation Lynn

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Sun, 01/27/2013 - 06:58

Jan Wesselink

Lynn, to not use the CVAD's

Lynn, to not use the CVAD's for sampling makes sense to prevent CLABSI. Could you please give the studies supporting this? I'd like to present it to my facility for consideration. Thanks

Sun, 01/27/2013 - 17:23

(Reply to #3) #4

lynncrni

First is a new set of

First is a new set of guidelines from Joint Commission. News Details | Joint Commission

Second is the INS standards of practice on phlebotomy, which calls for a patient specific assessment of the risk vs benefits of using a CVC for this purpose.

Third is Contamination rates of blood cultures obtained by dedic... [JAMA. 2003] - PubMed - NCBI

For a CVC, this is based on our knowledge of hub manipulation increaseing the risk of intraluminal contamination, biofilm growth, and BSI. So the thought is to decrease the BSI rates by decreasing hub manipulation to as little as possible.

Unfortunately, I am not aware of a specific clinical study that directly compares infection rates in CVC used for blood sampling and those not used for this purpose.

Lynn