Antibiotic Preparation..bedside or in hood?

[Guest odansby]

please share your antibiotic preparation and administration practices in your hospitals and if you have evidence based ones. I have heard talk all IV antibiotics prepared in the pharmacy clean room, including spiking and priming the IV tubing to help decrease contamination and infection rates. Do your nurses connect IV tubing bedside or does pharmacy connect in hood? Thanks!

[Schumz]

In our unit, the nursing staff prepare antibiotics and also attach IV to babies. Pharmacy check dosing, prescription and are responsible for preparing TPN. 

 

[Stefan Johansson]

In Sweden I think the practise is as in our unit - that ab is prepared in the NICU by nurses, incl filling syringes, tubes etc.

in our unit, all work related to medications (incl storage)is Done in a dedicated ”medicine room” where nurses work with predef instructions and without becoming disturbed. 

[cmcdermott]

In out unit the nursing staff prepare the medication in a designated corner of the unit.   Fluids are prepared and giving set primed at the cotside

[Hamed]

In our unit, all medications including IV fluids, TPN, and antibiotics are prepared by nursing staff in a medication room, which has a direct connection to the NICU. Antibiotics and tubing are prepared under the hood during wearing gloves, masks, overheads and disposable gowns. I didn't come upon an RCT comparing site of medications preparation.

 

[Kiran Kumar]

The 1st dose of antibiotics & Inotropes are prepared by our NICU nurses and all subsequent doses are prepared in central pharmacy. We prescribe the medications on SAP system which is accessed by Pharmacy team to prepare these medications. TPN is also prepared in Central Pharmacy

[Zuzana Tomaskova]

In Czech Republic we do prepare it bedside or in our hood in the unit. 

In Saudi we received it fron the pharmacy and connected tubing bedside (for CVL or PICC or UVC as sterile procedure). 

I do believe if you prepare it correctly bedside (clean environment, equipment, proper technique) theb you are safe but you have to know that your staff adhere to correct procedures which is sometimes very hard... But this is my opinion nothing from EBM. 

[gayle omansky]

Peripheral line antibiotics are prepped by nurses at a med station. Central line meds are prepped under hood in pharmacy. Tubing changes are done at bedside on a sterile field.

[bimalc]

Our abx come from central pharmacy in syringes.  Our bedside RNs connect to tubing at bedside.  I'm not on the specific committee, but there are periodic evidence reviews and pushes for specific practices to reduce CLABSI related to drug administration and I see the RNs doing things like 'scrubbing the hub' and using disinfecting 'Curos' caps (for which I do know there is reasonable evidence).  

I'm not aware of any evidence, but my experience suggests that probably the bigger gains in patient safety from moving to pharmacy dispensing are not in infection reduction but rather things like dose checking and interaction checking.  

[yasseralsadi]

our unit use special room inside NICU and all medication mixed and prepared by our medical staff and pharmacist but there is no hood