Our facility is trying to standardize our policies, physician orders, and documentationÂ concerning flushing protocols for all vascular access devices.Â Currently our policy is to flush PIV lines q8 hours (if not used for continuous infusions) and prn after each use with 3ml NS.Â We flush all central lines (except Diaylsis and Apheresis lines) q12 hours and after each use with 10mlÂ NS and 3ml 100:1 Heparin.Â We have managed to create an order set which spells out the flushing protocols for each line, but we're stuck on the documentation piece.Â Our pharmacy tell us flushes do not need to be documented in the medication record because the FDA has labeled flushes as devices and not medications.Â Is anyone out there documenting their PRN flushes of saline and Heparin in the medication record?Â If not there, are you documenting it someplace else?Â We are documenting the routine flushes on the medication record, but not the prn/after each use flushes.
There has also been concerned raised that we should be keeping track of these flushes in a patient's I&O record, particularly if they're in the ICU and getting multiple intermittant infusions throughout the day.
Has there been any research or are there articlesÂ or studies I could read aound this issue?
Any advise you could provide would be greatly appreciated.
Greg Bowman, RN
Clinical Supervisor, Vascular Access
Swedish Medical Center, Seattle WA