IV medication infusion flushes

[Jamie Canupp]

Good afternoon!  Just curious, how do other facilities/organizations handle IV medication infusions?  Do you hang Normal Saline (or another compatible fluid) to flush your IV antibiotic/medication lines to ensure that all of the medication has been delivered to the patient?  

[Amy Floyd]

At my facility- it is done both ways.  I will tell you I was appalled when I first came to work in the long term care facility ( this is Spinal cord and skilled rehab) that they were not hanging piggybacks as piggybacks, which allows the line to run dry- or leaves medication in the line for hours. I find both of these situations to be incorrect.  They do not do this in the main hospital section of the hospital.  They also change bags every 24 hours on fluids that are not continuous.  We change bags every 3 days on bags that are not continuous (long term care).  I have checked the IV infusion guidelines and it is rather ambiguous on this point.  I know many hospitals in the area have gone to 5 days for tuning to hang, but with a piggyback the medication will be flushed out and the tube is not dry. 
The data- last I checked- is rather scant in this area, so the administration has won this fight for the time being as it is a cost-savings means to not hang a saline bag for the with the IV medication. They consider it an acceptable risk in the long-term care setting, as opposed to the acute care setting where the medications are more critical- although my observation - we are talking about the same IV antibiotics in a very similar population.