Propofol is commonly infused through a Y-Port (generally along with Fentanyl) in our ICUs. As you probably know, Propofol is a nutrient rich emulsion that can potentially increase bacterial and fungal contamination of the IV line. My issue is that only the Propofol tubing is being changed every 12 hours while the "Y-port" extension that it's attached to is changed every 96 hours. My concern is that the "Y-Port" extension presents a high risk for contamination (bacterial & fungal) as it is exposed to Propofol for greater than 12 hours. It should also be noted that the needless connector that the "Y-Port" extension is attached to the central line is also being changed out every 96 hours.
I cannot find any literature/studies that validate my concern of contamination by leaving a Y-port extension with Propofol infusing for 96 hours. A dilemna we have is that patients in the ICU have multiple drips running and sometimes not enough venous access. This lack of access forces nurses to be creative and "Y port" multiple IV meds/drips. Ideally, we would like to have Propofol running on a dedicated line, but this is just not feasible. In summary, I feel that as a best practice, the Propofol line, Y-port extension, and needless adaptor should be changed out every 12 hours to prevent possible contamination.
Curious if anyone else has come across this in their practice or does your institution have a policy regarding this issue? Thoughts?
Chris A. RN, BSN, VA-BC, CRNI