The Effects of Saline Flushes on Taste and Smell · The Effects of Saline Flushes on Taste and...
Transcript of The Effects of Saline Flushes on Taste and Smell · The Effects of Saline Flushes on Taste and...
The Effects of Saline Flushes on Taste and Smell Crystal Rice, BSN, RN
Vanderbilt University Medical Center, Nashville, TN 37232
Background Results
Hypothesis
Methods
Results
Conclusion
IV catheters are routinely flushed with saline to maintain IV patency, which
is standard of care practice
Some patients have experienced a taste and/or smell when their IV catheter
is flushed with saline
IV catheters are flushed with saline from a commercially prefilled syringe
and/or saline from a multi-dose vial or bag depending on unit
policy/procedure and/or nurse preference
Commercially Prefilled Saline Syringes
- Advantages:
Allows nurses to be more efficient in their work flow
Manufacture labeling increases patient safety
Decreased risk of infection
Decreased medication errors
- Disadvantages:
Can cause the patient to experience a taste and/or smell when their
IV is flushed
Some reports of infectious outbreaks have been reported due to poor
compliance with the FDA’s quality system regulations and Good
Manufacturing Practices
Multi-dose Bags or Vials of Saline
- Advantages:
Cost effective
Patients are less likely to experience a taste and/or smell when their
IV is flushed
- Disadvantages:
Increased risk of infection
7.3 times more likely to experience a taste with the prefilled syringe when
compared with the multi-dose bag (p<0.001 McNemar’s Chi-squared test)
10.4 times more likely to experience a smell with the prefilled syringe when
compared with the multi-dose bag (p<0.001 McNemar’s Chi-squared test)
38 of the participants (77.6%) preferred the multi-dose bag of saline when
compared with the prefilled syringe (p<0.001 McNemar’s Chi-squared test)
Design: randomized, double blinded crossover study
49 participants were given three 10 ml injections of saline from a
commercially prefilled syringe and saline from a multi-dose bag
Each injection was separated by 30 minutes and given over 15 seconds
Each participant received saline from both the commercially prefilled
syringe and multi-dose bag
At the completion of each flush the participants were given a questionnaire
to evaluate their experience
o Participants were asked to choose which injection they preferred
Prefilled saline syringes will cause the patient to experience a taste and/or
smell after their IV catheter is flushed with saline.
Prefilled saline syringes cause the patient to experience a taste and/or smell after
their IV catheter is flushed with saline.
16
4
3
2
1 1 1
14
8
1 1
6
1
5
Metallic Alcohol Bitter Chemical Sweet Salty Other
0
2
4
6
8
10
12
14
16
18
Re
cord
ings
Taste Smell
The participants description of the taste and smell for the prefilled syringe
*Extra text
1
6
7
2
3
1
2
0 0
1
2 2
10
4
6
1
3
2
1 1
0
2
4
6
8
10
12
1 2 3 4 5 6 7 8 9 10
Re
cord
ings
Intensity Ratings for the prefilled syringe 0 being no taste or smell detected and 10 being the worst taste or smell detected
Taste Smell
The participants rated the intensity on a scale of 0 to 10
0
5
10
15
20
25
30
35
40
Prefilled Syringe Multi-dose Bag
11
38
Number of participants who prefer the prefilled syringe versus the multi-dose bag
0
5
10
15
20
25
Prefilled Syringe Only Multi-dose Bag Only Both
20
2 2
21
8 8
Number of participants who experienced a taste and/or smell when their IV was flushed with saline
Experienced Taste Experienced Smell
Acknowledgements: Christa Hedstrom, EdD, RN, CCRP; Nancy Wells, DNSc, RN, FAAN; Vicki Sandlin, MSN, RN, CCRP; Kathy S. Moss, MSN, MBA, RN, PMP, NEA-BC; Lana Howard, BSN, RN, CCRP; Deloris Lee, BSN, RN, CCRP; Mary Gwyn Bowen, RN,
MA; Daniel W. Byrne, MS; Li Wang, MS; Clinical Research Center Nursing Staff. This project was funded by VICTR (VR 1908), and in part by grant UL1 TR000445 from NCATS/NIH. The survey tool that was used was REDCap.