We use tubing with a filter on our continuous IV fluids on all central lines ( unless contraindicated). We have always connected our IVPB above the filter to use our smart pumps to their fullest capacity with exception to those that cannot be filtered (identified by the pharmacy). Our Educator is now telling everyone to bypass the filter and connect them below so they don't infuse thru the filter. What is the best practice and what is everyone else doing ?
Your educator is wrong and I am very curious as to why she is teaching this method. Piggyback medications is one of the most important fluids to be filtered in my opinion and I think your practice is far superior to most everyone else who does not filter these fluids. Small doses of low quantity (eg. 1 mL or so) may get trapped in a filter but a piggyback dose would not. If a filter is clogging and the pump is beeping occlusion, that is a very simple but powerful message that the filter is doing its job. If that filter had not caught all that particulate matter, it would end up in your patient's lungs! Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
I would also add that it is common practice to place the filter at the lowest point in the tubing (as close to the patient as possible) in order to catch any precipitate that might form while the drug is traveling through the tubing. Also, most antineoplastic drugs do not need to be filtered, so I am not sure what the evidence basis is for such universal filter use. For cost purposes and to prevent accidental use of a filter on a medication that should not be filtered, I would recommend reserving filters for medications that have been identified as requiring one and placing it immediately before the patient on the tubing.
Keith W. Gilchrist, MSN, RN, PHN, OCN, CRNI, VA-BC
Oncology Nurse Navigator, David Grant Medical Center
Travis AFB, CA
Pay close attention to the new INS Standard on Filtration coming in Jan 2016. We pay more attention to filtration of fluids put into our cars than we pay to fluids we put into our patients. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861