Reply To: Buretrols

  • Chris Donaghey

    Member
    February 5, 2014 at 5:18 pm

    Like others, we have had problems. Another nurse and I went through months of issues with this, involving meeting with our pharmacy multiple times to prove it wasn’t their fault and then, meeting with the pump manufacturer whose reps were far less than civil/helpful in how they approached the errors. Their errors were frequently more than 10%. We found we have had less issues when running our chemo as a primary infusion.

    For some time, we took to weighing bags with diaper scales. We had empty bags from chemo pharmacy to adequately zero them out (save the primed tubing volume). We then leave the diaper scale in the room. Every few hours, the bag could be weighed again to approximate total volume versus what the pump stated. It’s not a perfect practice, but it has made us far closer on our 24 hour infusions. We are changing pumps soon as well to some with less of an error margin, so that’s promising too!

    And we use an in-line system where we use adapter pieces to flush above the pump 15 mL at the completion. We rush a flush at the onset since the tubing comes primed with saline, so it’s accommodated at the end.

    240 mL bag for 24 hrs.
    Rush 15 mL.
    225 mL at 10 mL/hr.
    Flush 15 mL at 10 mL/hr at the end

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    Chris Donaghey, RN, BSN, CPN, CPHON
    Peyton Manning Children’s Hospital at St. Vincent
    Indianapolis, IN
    United States
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    Original Message:
    Sent: 02-05-2014 05:09 PM
    From: Cara Johnson
    Subject: Buretrols

    My answers are bolded 🙂

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    Our institution is transitioning away from buretrols That’s sad ;), and since the question comes up from time to time on this ListServ, we thought this would be a good place to ask some specific questions that would guide us:

    1. How do you track your 24-hour infusions so you can keep them on time? Depends on the infusion. The biggest issue has always been Methotrexate. I have worked in Oncology for 14 years and 7 different institutions and it is a problem everywhere. Hence the change in the protocol 😉 We try our best to complete within 26 hours and have also eye balled and increased the rate if needed.
    2. Does anyone weigh their chemo bags during 24-hour infusions? and if so – how often? Our pharmacy weighs them before sent and if 10% difference they remake and also keep the documentation
    3. How do you add your flush to the tubing at the end of the infusion? We use primary tubing and then flush at a port below the pump to infuse all the drug.

    Good Luck!

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    Cara Johnson RNIII BSN Clinical Manager
    cara.johnson@…cara.johnson@…>
    Cincinnati Children’s Hospital
    Inpatient H/O
    United States
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    Original Message:
    Sent: 02-05-2014 04:56 PM
    From: Ruth Anne Herring
    Subject: Buretrols

    This message has been cross posted to the following Discussions: Nurse Educators and Pediatric Chemotherapy Biotherapy Instructors .
    ——————————————-
    Our institution is transitioning away from buretrols, and since the question comes up from time to time on this ListServ, we thought this would be a good place to ask some specific questions that would guide us:

    1. How do you track your 24-hour infusions so you can keep them on time?
    2. Does anyone weigh their chemo bags during 24-hour infusions? and if so – how often?
    3. How do you add your flush to the tubing at the end of the infusion?

    Thanks for your input,

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    Ruth Anne Herring
    Fort Worth, TX
    United States
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