Are there specific guidelines regarding IV solution changes? If it is time for a hospital to change the administration set and the IV bag is still half full of solution or drug, is it acceptable to re-spike the IV bag with the new tubing or should the IV bag be discarded for a new one?
Do you mean the change frequency for the IV fluid container, be it bag, bottle, or syringe? If so, there is very little and what is out there is very old. After a nationwide outbreak of infusion related BSIs in the 1970's the guideline/standard was to change the container at 24 hours. This outbreak was traced to the design of the stopper on the glass bottles. Obviously, lots of practice, issues, etc have changed since then but the only work I know of is for specialty fluids like IVFE. The standard is to change the container and IV set at the same time. If a container will not be infused by the time that container is empty, then the set should be changed when that container is hung. Respiking a bag is never a good idea but I don't know of any guidelines statements about this issue. 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
Yes, Lynn, I was referring to the container change frequency, but specifically what the protocols are with regard to the IV container and "re-spiking" IV bags.
Thank you
Additionally, and as a point of clarification, Lynn, what exactly is meant by "If a container will not be infused by the time that container is empty"?
Sorry, typing faster than I was thinking. What I meant was if the fluid container will infuse longer than the time for the set to be changed, then the set should be changed when that container is hung. Example - 96 hours on set is ending at 2 pm. New bag is hung at 8 am for 12 hour infusion, will be empty by 8 pm. I would change the set when I hang the new bag at 8 am. 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
One final question related to this:
How have IV fluid shortages effected IV set/IV container shortages? Have modifications to established clinical protocols been made, secondary to shortages in IV solutions?
I have heard of several changes including changing from use of normal saline to other fluids not involved in the shortage. Or using 250 or 500 mL bags instead of liters. I have also heard from a compounding pharmacy that they have had to refuse business because they could not obtain the necessary fluids for diluting the drugs ordered. 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
As a result of these shortages, do you believe that IV bags are changed less frequently? In other words, even though the IV set is changed, do you think that clinicians are instructed to retain the currently hanging fluids, secondary to the IV fluid shortages/allocations? If so, is there any written documentation pertaining to this?
Thank you, Lynn
I have not heard of anyone extending the life of an IV bag due to the shortage and not seen any publications recommending to do that. 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