Will you share your nursing practice or policy related to concentration changes for continuous IV infusions? For example, if a patient is on a 1:1 epinephrine infusion and is being switched to a 4:1 concentration, how does the nurse set that up? I would assume that the new 4:1 concentrated bag is spiked with a new primary set so there isn't mixing of concentrations in the line--but what about the volume left in the catheter of the access site? Do your policies specify what should be done (load with drug, withdrawal previous concentration, etc.)? Or do you accept the risk with the "other" concentration being left in the catheter? We have special workflows in place for prostacyclin analogues, but not other medications. What is happening at your hospital?
Thank you,
Stacie Ethington, MSN, RN-BC
Medication Safety Nurse Specialist
Nebraska Medicine