Infusion Insight: Secondary Infusions Deserve Primary Concern

Susan Niemeier, MHA, BSN, RN, Chief Nursing Officer, Ivenix

Whether you call them secondary, intermittent, or piggyback — infusions that deliver fluids through a secondary line are a challenging but important part of IV medication administration. These infusions deliver medications that must be diluted and administered slowly over a set amount of time, whether as a single dose or periodically over prescribed intervals.

Secondary infusions often involve medications and antibiotics that demand careful setup and precise dosing, with both over- and under-infusion posing significant risk of patient harm.  Proper setup is also far more complex than for primary IV drug delivery.

While today’s smart pumps have reaped a number of meaningful drug delivery improvements, many clinicians assume that they were also designed to streamline and minimize the risk of error in secondary infusions. However, unfortunately, this rarely has been addressed.

What are some of the most frequent potential secondary drug infusion errors?  In a recent webinar sponsored by Ivenix and the AAMI Foundation, industry experts Bob Butterfield and Nathaniel Sims, MD, highlighted examples of these use errors. Perhaps the most common is simply forgetting to open the roller clamp during a busy nursing shift—which, of course, results in failure to deliver the infusion altogether.  Others include selection of the incorrect tubing, connecting to the wrong Y-site, allowing air into the system, and neglecting to lower the primary medication container to an acceptable level to allow the secondary medication to be administered.  All of these examples highlight the complexity of setting up and administering what should be a seemingly simple infusion.

At Ivenix, we believe the design of an infusion system should streamline secondary infusions and minimize the reliance on busy clinicians to address problem areas.  The Ivenix Infusion system provides a series of specially developed safeguards to address the major causes for secondary infusion errors.

If you’re considering upgrading or replacing your infusion system, take into account these important considerations:

• • • Dedicated inlets for primary and secondary lines
    • Sensing of a clamped secondary line
    • Automatic resolution of secondary line occlusions
    • Option to deliver via a syringe on the secondary inlet
    • Compensation for dead/shared volume issues
    • Support for complete medication delivery on the secondary line

 
For more information on how the Ivenix Infusion System can help cut through infusion complexity and put patients first, download our clinical backgrounder.