Reply To: Chemo bag overfill

  • Maria Camarda

    Member
    September 3, 2014 at 1:30 pm

    This is a HUGE issue for us. We used to do the weighing of the bags and for all the hassle we still were not finishing on time. Our pharmacy may use let’s say a 250 ml bag of NS that is from the manufacturer and then add the chemo to it…the problem is that the bags that say 250 may have 225 or the may have 275 in it…and that of course affects us finishing it on time….I fight with them to hand prime every bag but they say it takes too much time….so the battle continues

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    Maria Camarda
    Kaiser Permanente Medical Center
    Sunnyvale, CA
    United States
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    Original Message:
    Sent: 08-11-2014 02:41 PM
    From: Chris Donaghey
    Subject: Chemo bag overfill

    It’s a very tricky issue. Our institution has gone through 3 pumps in the past 5 years or so because of these very issues and because a small contingency of us became extremely fed up at the extreme errors. We had pumps in the past that had a +/- 10% accuracy rate on them..and with lab draws, blood return checks, and on 24 hour bags, 10% can get you off an hour or two if you don’t watch it extremely closely.

    We had our pharmacy recalibrate their machines multiple times. We had reps from our pump’s companies come to our hospital and argue up the issue with a couple of nurses (myself included) and see the process from start to finish. And the answers were far from satisfactory.

    Currently, we’ve made the switch to the Alaris pumps and while issues remain (bicarb making air in line alarms go off, etc.), our accuracy has improved.

    I think it’s essential to know their stated accuracy allowance. An extra few percentage points can make a huge difference with running dry, late, or just right.

    And otherwise, you can try specific systems to get around it in the meantime. We weighed dry bags that the medication came in along with our tubing, weighed the bags and tubing at the start of the infusion with the bedside diaper scales and a zeroed out basin, and kept doing so at a regular basis (and with increasing frequency as the time it was to be complete neared). 

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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: 08-11-2014 02:14 PM
    From: Traci Marsh
    Subject: Chemo bag overfill

    Hello all,

    We are currently having some issues with the amount of overfill noted in our chemotherapy bags, more commonly Ifosphamide and Etoposide. I was just curious to see if anyone else has issues with overfill in the bags and if so what do you do to correct or help with that issue. We have already spoken to pharmacy and they state they do everything correctly on their end. I wasn’t sure if anyone weighed the bags to do calculations or not? If so, how does that seem to work for your institution? Any advice, research, direction would be greatly appreciated.

    Thanks,
    Traci

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    Traci Marsh
    Guyton, GA
    United States
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