In our presurgical area the techs and or nurses are spiking IV bags in the early morning and running tubings through with the fluids., then leaving them sit until they need one for each patient. At the end of the day they throw out what isn't used. I am concerned with the practice. I am of the opinion if I did not spike it I cannot assume it was done properly. I would not hang a bag that was spiked and left in the nursing station for several hours. I understand that work flow etc make it more efficient to prime a bunch of tubings ahead of time for a busy day but still don't think this is the best practice.
I am looking for feedback as to what others think on this.
Jose Delp RN BSN
Clinical Nurse Manager IV Team
Upper Chesapeake Health
Jose Delp RN BSN
CliClinical Nurse Manager IV Team
Upper Chesapeake Health
Well, I guess opening these bags on the morning of the day of use is better than the night before. But I have serious concerns about lots of open fluid containers and sets hanging around. Who is monitoring these open containers? Where are they being stored? How are they stored - hanging or lying flat? What are the chances of the tubing end caps falling off and contaminating the tubing and it still being used? What are the chances of someone injecting a drug into one or more of these bags? I would be extremely uncomfortable with the situation also.
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
I would refer you to USP chapter <797> and the July 08 update that defined
and gave instruction of "immediate use CSP" July is when USP <797> came out of the pharmacy and on to the floor. You have one hour to use by these guidelines.
Craig Farris RN, CRNI
Clinical Nurse Educator
Craig Farris RN, CRNI
Clinical Nurse liaison
USP <797> applies to compounding of sterile products. This includes IV and any other compounding of medications that must be rendered in a sterile manner. The simple act of opening and spiking a fluid container does not equal any form of compounding so I think you will get lots of resistance if you try to use 797 to justify not opening these containers and sets before use. I strongly agree that this is very bad practice, but I don't think 797 applies to this. Would love to hear from a pharmacist on this issue.
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