I have recently taken a position as Infusion Coordinator for a community hospital. This is a new position to their facility. Prior to me coordinating OP infusions the patients would come into the ER for OP infusion and their were no specific guidelines to follow. I am trying to implement some standards and policies, but I am meeting some resistance to change. The OP facility I came from was a chemo/infusion center. We would use a 100 ml bag of NS to use to prime the tubing and to use as a flush. I have been using the saline as a primary and the therapy medication as a secondary. Are there any recommendations on using NS as a primary or for a flush? I do like using it to ensure that the patient receives all his/her medication. Would appreciate some suggestions or articles to provide to staff.
Thanks!
The primay concern is the amount of drug left in the administration set without a post-med saline infusion If you are using an infusion pump, the residual in the set could be up to 50% of the dose. So you can't waste that large amount. If you are not using a pump and using just a straight primary intermittent set by gravity, I do not see a reason for this piggyback method. So it depends on pump use and the volume of med left in the set. 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
That if the IVAB was in 50cc NSS, say like a Cubicin medication, and it's once a day dosing, then with our tubing holding 17cc, that is approx. 33 % left in the tubing. So, imo, it should be given as a secondary, or given IVP. If you are infusing this by gravity and counting drops, this isn't acceptable.
Is there any recommended guidelines available regarding Intra-articular Infusion?
Not in the INS Standards of Practice. That document includes intravenous, intraspinal, intraosseous, and subcutaneous infusions. If you are asking about intra-articular antineoplastics, you should check with ONS. If you are asking about SC infusion into surgical sites for pain control, you should check the documents from pain management organizations. 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