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borunda
Line infections in Home TPN pt.

I have a patient who has had many lines pulled due to infections.  She is 52 y/o with a paralyzed bowel and will be on TPN the rest of her life.  She also needs other medications IV so always has a double lumen line.  We have tried ports and tunneled and non tunneled and antimicrobial catheters. 

I remember a conference in Anahiem where Dr. Maki spoke about using an alcohol solution to lock the catheter but cannot find anything in the literature.  Does anyone know if he wrote this up or if there is an article out there? 

 

lynncrni
There is now a lot of

There is now a lot of published literature about using ethanol in a variety of concentrations to treat CRBSI. You can easily do a lit search or go to the INS website and locate the 3 webinars I gave last year on catheter patency. The third in that series included a lengthy discussion of these alternative flush solutions and there is a long list of references. 

 

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

www.hadawayassociates.com

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

We had the same problem with
We had the same problem with a long term TPN patient.  Frequent line infections and the pt/cg was doing an excellent job with the TPN administration.  They were very vigilant about cleaning caps and we felt education was not the problem-as a matter of fact they were much better at following infection control practices than the nurses that were involved in her care in the hospital when she got admitted for treatment.  We eventually switched her to gentamycin/citrate flushes with excellent results.  It has been several months now with no infection, whereas before she was getting admitted about once or twice a month.
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