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Tue, 11/28/2006 - 15:06

DML RN

New IV tubing with new site--PIV and PICC

If I recall right,the INS standards call for new IV tubing to be used when a new PIV site is placed. I can't remember if the standards say specifically to do the same for a new PICC,and my standards seem to have not been returned last time I loaned them. I always ask that my new PICC's get new IV sets,but want to know if that's in the standards,a 'best practice' or just me.

Thanks,

David

Tue, 11/28/2006 - 15:26

lynncrni

INS SOP states that the

INS SOP states that the primary set change shall coincide with peripheral catheter change and with initiation of a new container of solution. They also state that sets should be changed when the integrity of the set or system has been compromised. Given the fact that the set has been connected to another catheter hub (risk of touch contamination) and used for a period of time for infusion and has probably had several connections of other tubing or syringes, I would say that all sets should be changed when any new catheter is inserted. New catheter requires a new set. In other words, set use implies the potential for the integrity to be compromised, therefore a new set should be used. The SOP does not specificially state this, but I believe it is implied and is best practice. 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

Thu, 04/19/2007 - 15:13

Rhonda Sandlin

Lynn, I have a question

Lynn,

I have a question for you. One of my field nurses was going to a patient's home to do her weekly port a cath needle change and was changing the tubing as well. The patient is receiving Morphine PCA. ( Basal rate and bolus dosing). So it is considered a "continuous infusion". However, when she went to change the tubing, the bag of Morphine was still half full. She wasn't sure what to do with the bag and called our pharmacy. The pharmacy instructed her to respike the bag with the new tubing to allow finishing the bag of Morphine. My response to this was that she should have spiked a new bag of Morphine because respiking the old bag is risk of contamination. I looked everywhere in the INS standards to back up my advice and while INS standards state that the administration set should be changed, nothing is stated regarding the bag. I was always taught that the bag becomes part of the administration set, therefore, when you change needle and tubing.....bag of infusate would be changed also.

Our pharmacy mixed up a bag that would last for 10 days (they said Morphine is stable for that long) but you would think that they would only make up enough to last through the weekly port needle change so everything would be fresh when the nurse went to reaccess the port with new needle and tubing.

I would love anyone's input on this please!

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