Does anyone have a resources for the correct usage of tubing (set-ups). For example, a single antibiotic administered via gravity. Do you hang on straight gravity tubing 85" or do you hang a primary flush bag and secondary the med in. This is the kind of info. I'm looking for. More specifically, when a single med is infused via gravity, some med remains in the tubing and having a flush system eliminates this but also has the patient receiving additional solution. Any answers?
Also, are IV time tapes for primary solutions (gravity infusion) a thing of the past? Somehow the use of time tapes has disappeared in our facility and we do not have the luxury of having pumps for every patient. I can't imagine how people "know" the patient is receiving the correct amount of fluid.
There is no single "best" tubing set up that will work for every patient in every setting. I have seen intermittent meds given by a direct connection to the needleless connector and gravity infusion. I have also seen normal saline used as a carrier solution with all meds piggybacked into the saline. Do you have a problem with nurses not immediately disconnecting meds when they are finished? If so, I would recommend you use a carrier fluid. If you are in an outpatient setting where nurses are closely monitoring infusions, direct connection is the least costly. Just remember that every second that the tubing is connected without some infusion running, there will be blood reflux into the catheter which will lead to occlusion over time. RE the small amount of residual left in the tubing, I have never found this to be of any serious concern because it is a relatively small amount of fluid, probably less than 1 mL. RE time tapes on all primary fluids, I still teach this and think it is a good practice. Just think about all the recalls of infusion pumps recently. That tape is a simple method to provide an additional check to determine is the proper rate is infusing. This is just too easy to overlook in my opinion.
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
My question about using a carrier fluid is where is the order to cover that? Is using a carrier fluid out of the scope of a nurse's practice? I know that state by state is different, but where is the order to cover that saline bag?
Gwen Irwin