Sharing fluids: right to be concerned or over reaction in something that does not concern me ??

RE: Sharing fluids: right to be concerned or over reaction in something that does not concern me ??

murphy-x — Sat, 19 Dec 2015 03:06:16 GMT

We use the same 1L bag for our routine surgeries: castrates, speys, dentals etc. as standard (all orthos have their own). We place and extension and t-connecter on the giving set that is changed in between each patient. The clients have it on their invoice but it is discounted back to zero. Personally I still don't know how I feel about it, I would love each patient to have their own bag, but then the clients will have to pay for a full bag which the patients may not receive all of it. At least this way the patients will receive the fluids, which we all know is needed during the surgery. Obviously it depends on the patient as well, patients that will require IVF pre and post op, or if the vets request it, will have their own full bag and giving set and the client will be charged in full which is then disposed of after. The surgery fluids, if any remaining, are disposed of at the end of the surgery list.

RE: Sharing fluids: right to be concerned or over reaction in something that does not concern me ??

denise laughlin — Thu, 17 Dec 2015 02:50:41 GMT

I think we are all in agreement that the client should be getting what they are paying for, as is appropriate in any business.

Smaller bags are not always cheaper, as I found when working in charity practice and trying to avoid wastage.

RE: Sharing fluids: right to be concerned or over reaction in something that does not concern me ??

Anneke Kuipers — Thu, 17 Dec 2015 00:13:07 GMT

I would say, if they owner pays for a full bag they should get a new bag each time!!

if wasting left over fluids is the problem, look into smaller bags: 100 and 250ml bags

RE: Sharing fluids: right to be concerned or over reaction in something that does not concern me ??

denise laughlin — Wed, 02 Dec 2015 19:02:38 GMT

I'd be interested to read any evidence based responses to this thread.

For the client, I am outraged, they should not be paying for fluids in these cases of course but before we decide if animal welfare is being compromised, it would be great to have some clinical assessment of the risk..anyone?

Not referring to this specific case but if the giving set was managed aseptically is it OK?

if the likelihood of blood borne pathogens is low is it OK?

will a needle free valve prevent contamination or minimise?

I'm not advocating this practice, but a constructive discussion would be interesting.

RE: Sharing fluids: right to be concerned or over reaction in something that does not concern me ??

Fay Cavanagh — Wed, 02 Dec 2015 18:40:20 GMT

T connectors and needle free valve are used on most dogs already but not so much on cats. But will this stop all cross contamination? When not in use the giving set is often not managed in a sterile manor. And theres still the cost to the client, they are paying for something they aren't getting.

I worry about the practices reputation as they do have a lot of work experience, locums and students pass through.

Just so everyone is clear I don't participate in this sharing when I work there. As an RVN I believe its my right to say no to something I am not comfortable doing.

RE: Sharing fluids: right to be concerned or over reaction in something that does not concern me ??

Sal the 1st — Sun, 29 Nov 2015 10:48:40 GMT

[quote user="Ben Ogden"]

if such a thing was to 'get out' through a work experience person (etc etc) it could damage the business's reputation?

[/quote]

or even a forum like this one - the damage may have already been done? Don't forget it isn't unknown for MOPs to come on this site.

which is why I was disappointed this hadn't been dealt with in house.

and not forgetting this

http://www.vetnurse.co.uk/f/5/p/20145/139503.aspx#139503

RE: Sharing fluids: right to be concerned or over reaction in something that does not concern me ??

Ben Ogden — Sun, 29 Nov 2015 08:59:27 GMT

[quote user="Sal the 1st"]

[quote user="NickyVN"]

Could they not at least invest in extension sets and t connectors or ports as just connecting the admin set straight onto catheter there will definitely be contamination.

[/quote]

yes a suggestion to use one of the one way valved injection caps might go down with senior staff as a positive rather than a criticism and might be more acceptable - just cant remember the name of the blimming things (the ones you use so you can disconnect fluids to take the dog out for a pee and reconnect when you bring it back in - I know its a needle less port but cant remember its name)

[/quote]

These little rascals are the most cost effective and reliable needle-less Y(or T) connectors on the market if you are at the very least trying to improve what is a bad situation. At least this sets some cross contamination distance between the catheter and multi share "Pass the drip bag 'pon the left hand side".

Will the senior staff at least accept that charging every client for full fluid bags the patient isn't technically is bad practice and if such a thing was to 'get out' through a work experience person (etc etc) it could damage the business's reputation?

This sort of behaviour impacts the image of the whole profession, perhaps if your senior staff were to 'stumble' across the opinions of their peers they may feel compelled to change their practices. Nobody likes to be vilified for there actions but sadly when habits are well established it takes a real jolt to encourage change. Although I would say, i'm a review and overhaul sort of person >.>.....

RE: Sharing fluids: right to be concerned or over reaction in something that does not concern me ??

Sal the 1st — Sat, 28 Nov 2015 13:47:52 GMT

[quote user="NickyVN"]

Could they not at least invest in extension sets and t connectors or ports as just connecting the admin set straight onto catheter there will definitely be contamination.

[/quote]

RE: Sharing fluids: right to be concerned or over reaction in something that does not concern me ??

Nicola Smith — Sat, 28 Nov 2015 13:34:50 GMT

Could they not at least invest in extension sets and t connectors or ports as just connecting the admin set straight onto catheter there will definitely be contamination.

RE: Sharing fluids: right to be concerned or over reaction in something that does not concern me ??

Sal the 1st — Sat, 28 Nov 2015 13:34:36 GMT

[quote user="Fay Cavanagh"]

I currently work for a multi branch company, each are run slightly different despite being the same company. I have worked at all of them at some point during my employment. One of the branch which is also a 24 hour hospital had introduced the sharing of fluid bags on routine procedures. This was after the senior vet read an article of the length of time a bag could be open for before the introduction of bacteria. Prior to this, all bags were disposed of after 3 days, they were not used between patients (for iv use). I was covering at this particular branch recently. I have discovered that this situation has advanced further....... All bitch spays get fluid therapy, prior, during and post surgery, (it is company policy) the cost of the spay reflects this. This particular branch is now sharing bags between bitches on the same day despite the client being charged for it. In one day a 500ml bag could have been used on several different animals, without changing the giving set. I find this unethical and immoral but to mention the unnecessary risk the animals are being exposed to. Has any one else had experience of this or could offer some advice on how to address this as last time I approached the head nurse about the situation and my feelings it didn't go well.

[/quote]

disappointing this could not be resolved in house

RE: Sharing fluids: right to be concerned or over reaction in something that does not concern me ??

WelshyNurse — Sat, 28 Nov 2015 12:38:22 GMT

That's terrible! I really don't know what to advise you but this is shocking