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Peripheral Intermittent Infusion Device (PRN Lock). Evidence Based Practice. Clients who received intermittent IV therapy via a saline lock were more independent with regard to ability to perform self care ADLs than those who received continuous IV therapy. Normal Saline VS. Heparin.
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Evidence Based Practice • Clients who received intermittent IV therapy via a saline lock were more independent with regard to ability to perform self care ADLs than those who received continuous IV therapy
Normal Saline VS. Heparin The American Journal of Health- System Pharmacy states the following: • 0.9% sodium chloride is the preferred method over heparin flushes • 0.9% sodium chloride is as effective and is safer due to decreased potential for adverse effects • 0.9% sodium chloride avoids drug incompatibilities • 0.9% sodium chloride is a cost-effective alternative
Site Changes • The CDC recommends: 1.) There is no need to replace IV sites more frequently than every 72-96 hours 2.) Changing sites prevents phlebitis and catheter related infections 3.) These risks increase >72 hours 4.) 72-96 hour intervals reduce risk for infection as well as patient discomfort
Evidence Based Practice • The British Journal of Nursing states: 1.) IV route is a portal of entry for infection 2.) Health care workers should see every patient as susceptible to infection 3.) Follow standard infection control regarding IV care 4.) Scrub the hub for at least 15 seconds and let dry 30 seconds 5.) Strict asepsis regarding any hubs, ports, or infusion lines is crucial to decrease risk of infection
References • Ackley, B. J. & Ladwig, G. B. (2011). Nursing Diagnosis Handbook, 9th edition. St Louis: Mosby Elsevier. • Benner, K. & Lucas, A. J. (2012). ASHP therapeutic position statement on the institutional use of 0.9% sodium chloride injection to maintain patency of peripheral indwelling intermittent infusion devices. AmJ Health-Sys Pharm, 69, 1252-1254. • Lavery, I. (2010). Infection control in IV therapy: a review of the chain of infection. British Journal of Nursing, 19, 6-14. • O’Grady, N. P., Alexander, M., Burns, L. A., Dellinger, E. P., Garland, J., Heard, S. O… Saint, S. (2011). Guidelines of the Prevention of Intravascular Cather-Related Infections. Retrieved from http://www.cdc.gov/hicpac/pdf/guidelines/bsi-guidelines-2011.pdf. • Perry, A. G. & Potter, P. A. (2009). Fundamentals of Nursing, 7th edition. St. Louis: Mosby Elsevier.
