Our organization recently changed the administration time of Zosyn (piperacillin/tazobactam). Patients with normal kidney function will receive Zosyn 50ml over 4 hours (every 8 hours). Due to the slow administration rate 12.5mL/hr. it is infused via pump with a carrier solution. Problems have been identified with this.
1. Our infusion pumps are not smart pumps where the administration rate can be programmed to speed up and slow down. Its one rate primary rate and piggyback rate.
2. Our pump tubing is 27ml. The piggyback tubing is 8ml.
So, we had been setting the pump for 4 hours but the 1st 2 hours is just the carrier fluid. Then the patient received the med at 12.5ml/hr and then the carrier fluid would take another 2 hours to push the med through. The pharmacist working on this change states the med has to be delivered over 4 hours.
We cannot figure out how to meet this standard without changing our nursing practice of infusing antibiotics without a carrier fluid, back flushing, etc.
Other hospitals have switched to 4 hour infusions but they either have smart pumps or have not identified this problem.
The only other option we can come up with is to have the Zosyn infuse continuously. This would tie up infusion pumps for only one med. We do not have enough for every patient as it is.
Any thoughts??? Am I missing something??