Non-flushing of IV administration sets: an under-recognised under-dosing risk

COOPER, Dawn, RASSAM, Thomas and MELLOR, Adrian (2018). Non-flushing of IV administration sets: an under-recognised under-dosing risk. British Journal of Nursing, 27 (14), S4-S12.

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    Abstract

    Background: intravenous (IV) drugs are administered widely and under-dosing can result in therapy failure. The aim of this study was to quantify frequency, volume and dose of drug discarded within administration sets in the clinical setting. Methods: residual volume for 24 different administration sets was measured under controlled conditions in a laboratory. Clinical assessment of current practice regarding post-infusion flushing occurred in 6 departments of one teaching hospital in the UK over 7 days. Details of drug last infused, (concentration, diluent and volume) and type and brand of administration set were collected. Results: 74% of administration sets were not flushed. Non-flushing exceeded 90% and 61% for gravity and pump infusions respectively (p<0.001) in all areas excluding oncology. Oncology was the only area where flushing was standard practice for all infusions (p<0.001). Mean residual volume of the administration sets was 13.1 ml and 16.7 ml for gravity and pump sets respectively. Antibiotics were commonly infused and up to 21% of antibiotic dose was frequently discarded. Conclusions: the findings suggest disposal of substantial volumes of drugs occurs frequently in general hospital areas. Without clear national and local policies this unrecognised under-dosing will continue.

    Item Type: Article
    Additional Information: ** From Crossref via Jisc Publications Router.
    Uncontrolled Keywords: General Nursing
    Research Institute, Centre or Group - Does NOT include content added after October 2018: Centre for Health and Social Care Research
    Identification Number: https://doi.org/10.12968/bjon.2018.27.14.s4
    Page Range: S4-S12
    SWORD Depositor: Margaret Boot
    Depositing User: Margaret Boot
    Date Deposited: 09 Aug 2018 14:36
    Last Modified: 16 Nov 2018 14:10
    URI: http://shura.shu.ac.uk/id/eprint/22227

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