All questions are shown as received by the Trust.
Q1a. With regards to administration sets (pump and gravity) used to infuse IV antibiotics, does your institution have a policy to flush the administration set to give the full dose of antibiotics in accordance with the following guidelines?
• The Royal Marsden Manual of Clinical Nursing Procedures, Tenth Edition, Chapter 15, which states: “After completion of an intermittent infusion, an appropriate diluent solution should be administered via the administration set. This is to ensure the full dose of medication has been administered to the patient.”
• The “MEDUSA” injectable medicines guide instructions on how to administer intermittent infusions, which states: “Flush the administration set before it is disconnected with sufficient volume of sodium chloride (or compatible diluent) to ensure the total dose is given. Flush at the same rate the medicine was administered.”
• The National Infusion and Vascular Access Society (NIVAS) “Intravenous Administration of Medicines to adults: Guidance on ‘line flushing’ Version 3 2021”, which states: “‘At the end of the infusion, the medicine remaining in the infusion set should be flushed with sodium chloride 0.9% or other compatible diluent, using one of the methods described below.”
Q1b. If the answer to Q1a is “yes”, is your organisation fully compliant with your policy to flush the administration set to give the full dose of antibiotics in accordance with guidelines?
Q1c. If the answer to Q1a is “yes”, do you follow method 1 or 2 as outlined by the NIVAS guidelines linked above?
Q2a. With regards to administration sets (pump and gravity) used to infuse IV antibiotics, if you do have a policy in place to flush the administration set, have you audited compliance with this policy?
Q2b. If the answer to Q2a is “yes”, can you share the audit results? If so, please provide a copy as an attachment to your response to this FoIR.
Q3. What education measures have you put in place to ensure healthcare professionals in your organisation understand:
a. The existing guidance on flushing administration sets that are used for IV antibiotic infusions (as laid out in the sources above)?
b. The patient risks involved with failing to flush the residual volume of IV antibiotics in the administration sets?
c. The possible effects of not flushing the IV administration set containing IV antibiotics on antimicrobial resistance?
Q4. With regards to administration sets (pump and gravity) used to infuse IV antibiotics, which of the following (if any) are included in your policy with regards to disposing of the administration set and residual volume of either the prescribed antibiotic or flushing solution?
a. Complete administration set (including drip chamber with sharp) is disposed of into the yellow bag.
b. Complete administration set (including drip chamber with sharp) is disposed of into the orange bag.
c. Complete administration set (including drip chamber with sharp) is disposed of into the sharps bin.
d. Drip chamber/sharp are detached from the administration set line and the drip chamber/sharp disposed of in the sharps bin and the rest of the administration set line disposed of in the yellow bag.
e. Drip chamber/sharp is detached from the administration set line and the drip chamber/sharp disposed of in the sharps bin and the rest of the administration set line disposed of in the orange bag.
f. Other (please state)
