More and more I am finding nurses giving 2 antibiotics, piggybacking through the same IV site. They do this to "save time" or because "they were both ordered for 10am". I don't think this is acceptable, any other opinions?
Are you saying that they are infusing 2 medications at the same time through the same site? Or are you saying they are using the same site for sequential infusions of multiple drugs? The first is bad practice for many reasons but the second is not.
Giving multiple drugs through the same tubing and catheter at the same time risk drug incompatibility which can occlude the tubing and catheter, risking the loss of that catheter. The effectiveness of each drug could also be altered by this change in the physical and/or chemical structure of each drug - meaning loss of therapeutic effect and no clinical response to treatment. The response about the "time each drug was ordered" is not appropriate either. I have never seen a hospital situation where a physician ordered for drugs to be given at a specific time. This depends upon when the drugs are available from the pharmacy. Nurses set those times with IV meds being given ASAP or STAT as appropriate, but 2 drugs should not be infused together as a general rule. Finally if there is a reaction to one drug, you would not be able to determine which drug caused the problem. There may be some combinations that are acceptable for simultaneous infusion but this would require assessment of the most recent stability and compatibility data and then done only in emergent situations. This means access to a pharmacist with knowledge in interpreting this data. Factors include the time the drugs are in contact, the order in which they are mixed, the light as a source for energy to change the drug, etc. So this saving time idea could easily be costing your patients a lot!
Yes, infusing both medications at the same time, into the same piv access. One of the medications was Vanco. with the other antibiotic being piggybacked into the Vanco.
Are you saying that they are infusing 2 medications at the same time through the same site? Or are you saying they are using the same site for sequential infusions of multiple drugs? The first is bad practice for many reasons but the second is not.
Giving multiple drugs through the same tubing and catheter at the same time risk drug incompatibility which can occlude the tubing and catheter, risking the loss of that catheter. The effectiveness of each drug could also be altered by this change in the physical and/or chemical structure of each drug - meaning loss of therapeutic effect and no clinical response to treatment. The response about the "time each drug was ordered" is not appropriate either. I have never seen a hospital situation where a physician ordered for drugs to be given at a specific time. This depends upon when the drugs are available from the pharmacy. Nurses set those times with IV meds being given ASAP or STAT as appropriate, but 2 drugs should not be infused together as a general rule. Finally if there is a reaction to one drug, you would not be able to determine which drug caused the problem. There may be some combinations that are acceptable for simultaneous infusion but this would require assessment of the most recent stability and compatibility data and then done only in emergent situations. This means access to a pharmacist with knowledge in interpreting this data. Factors include the time the drugs are in contact, the order in which they are mixed, the light as a source for energy to change the drug, etc. So this saving time idea could easily be costing your patients a lot!
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