Quoting the text on the INS Standards "There is an absence of studies addressing administration set changes for intermittent infusions". The respective committee reached consensus to establish 24 h as a safe practice in lack of evidence.
This needs a more indepth explanation. There are absolutely NO studies on IV administration sets that have included data on any secondary or intermittent set. ALL studies have looked at the primary set - connected to the fluid container and the VAD- and never disconnected from the VAD until the designated time. The original standard for length of set use was 24 hours set back in the 1970s by CDC. No studies on intermittently used sets means that the Standards Committee cannot go beyond this original length of time. Think about what is happening with an intermittent set. A new fluid container is attached every 4, 6, 8, 12 hours. The male luer end is connected and disconnected with each dose of medication. All this manipulation means contamination but there is no data on the level of contamination. It is my personal opinion, given how many sets are maintained - without adequate scrubbing of the needleless connector, without a new sterile cover on that male luer end of the set, or covered with reused syringe tip caps, or a foil packet from an alcohol pad, or connected to an comtaminated injection site on the same set - that these sets should probably only be used for a single dose. Again my opinion only and no data. CDC has always stated that all VADs must be accesssed only with a sterile device. Can you really say that the male luer end of a reused intermittent set remains sterile after a single use?
Hi Deb!
Quoting the text on the INS Standards "There is an absence of studies addressing administration set changes for intermittent infusions". The respective committee reached consensus to establish 24 h as a safe practice in lack of evidence.
Francisco Cuesta
(858)263-9024
This needs a more indepth explanation. There are absolutely NO studies on IV administration sets that have included data on any secondary or intermittent set. ALL studies have looked at the primary set - connected to the fluid container and the VAD- and never disconnected from the VAD until the designated time. The original standard for length of set use was 24 hours set back in the 1970s by CDC. No studies on intermittently used sets means that the Standards Committee cannot go beyond this original length of time. Think about what is happening with an intermittent set. A new fluid container is attached every 4, 6, 8, 12 hours. The male luer end is connected and disconnected with each dose of medication. All this manipulation means contamination but there is no data on the level of contamination. It is my personal opinion, given how many sets are maintained - without adequate scrubbing of the needleless connector, without a new sterile cover on that male luer end of the set, or covered with reused syringe tip caps, or a foil packet from an alcohol pad, or connected to an comtaminated injection site on the same set - that these sets should probably only be used for a single dose. Again my opinion only and no data. CDC has always stated that all VADs must be accesssed only with a sterile device. Can you really say that the male luer end of a reused intermittent set remains sterile after a single use?
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