The Standards of Practice indicate that primary administration sets are changed every 7 days. Is the beginning of the 7 days time period begin when the administration tubing is taken out of the sterile packaging or when the administration set is connected to the patient's VAD? As a phamacy should we be sending pain medications with the tubing attached and primed or have the nurses prime the tubing just before starting the infusion?
Thank you
USP 797 states that the opened set should be used within 4 hours. The time usually startes when the set is opened because it is immediately attached to the fluid container and infusion begun immediately. So opening for any circumstance should be the start of this period. No set should ever be attached to any container and left UNprimed, that is asking for an air embolism! Hazardous drugs should be primed inside the laminar airflow workbench. For other nonhazardous drugs, this is a policy that must be decided by your facility. The INS Standards of Practice are not written as procedures with this level of procedure detail.
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
If I am understanding correctly the infusion should be started within 4 hours of the opening of the primary tubing set. That 4 hours would go toward the 7 day primary tubing change. Is that correct?
Sheri Idol
The 4 hours comes from USP<797> and the 7 days comes from the INS Standards based on new studies. I would apply this 4 hours to be included in the total of 7 but that is not stated anywhere. I would also work toward reducing that 4 hours. Also look at how well those bags and attached sets are monitored in that 4 hour period. Many OR suites want to open, attach and prime the set in the evening before surgery the next day, leaving them unattended overnight. This could allow someone to disrupt caps or even inject something else into those bags.
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