We have questions regarding the interpretation of 'primary infusion set changes'. This specifically relates to PCA infusions and hospice patients in the home infusion realm. A pca infusion is spiked and primed under the hood. Example that port is accessed on Monday and infusion started. New bag needed on Friday. POrt reaccess due on Monday again. 1) Do we need a new bag/tubing on Monday or can we disconnect and protect end, reaccess, and reconnect the current bag. There are often issues with 'wasting' medication for patients.
2) There is also some extended sterility and stability for medications with 9 days for sterility (re USP 797) and stability for 14 days. Can we do our weekly reaccesses and continue to use the one bag for up to 14 days. Seems that the standards address infusion set but what about long term infusions--doesn't seem to address the container itself.
Thank you
What do you mean by "port"? Implanted port? Injection port on another IV set? SC needle?
I don't understand what you mean by "port reaccess due on Monday again."
If the PCA infusion set is the primary continuous set (see definition in the back of Standards book), then it should be changed every 96 hours. Why would one set be changed at 96 and the second set be changed at 72? Is this a staffing issue to get certain procedures all performed on the same day? If so, I would say this can not and should not apply to this situation. Whether you are talking about accessing an implanted port or connecting to a new SC device or a new peripheral IV catheter, the set always should be changed due to the manipulation and the potential for moving a contaminated set to a new device.
Do the long term infusion sets have injection sites? Again, reaccess what? I suspect this USP sterility data is for the medication in the container and before an IV set has been added. Addition of a set, especially one where other injections are possible, increases risk of contamination, regardless of sterility data on the medication alone.
I am sorry but I don't understand your questions well enough to provide good information. If this was not addressed in the 2011 Standards, then we did not find any studies or discussion in a textbook chapter to use for writing a standard. Sorry but we can't just make it up, got to the the evidence. 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