IV Solutions

• Never use intravenous solution containers (e.g.bags or bottles) to obtain flush solutions, etc. for more than one patient.
• Never use infusion supplies such as needles, syringes, flush solutions, administration sets or intravenous fluids on more than one patient.
• Begin/initiate administration of spiked IV solutions (IV bag entered by the tubing spike) within one hour of preparation. If administration is not begun within 1 hour of spiking the bag, the IV and tubing shall be promptly discarded.
• For unspiked IV solutions (not accessed by IV tubing spike) follow the pharmacy prepared or manufacturer prepared IV solution expiration date.
• Use a USP 797 pharmacy clean room (ISO 5) to prepare admixtures of IV solutions.
• Disinfect IV ports using friction and 70% alcohol15, an iodophor15 or an approved antiseptic agent. Allow to dry prior to accessing.
Note: The USP 795 is for compounding of non sterile products and USP 797 is Compounding Sterile Preparations.

• Always follow the manufacturer's instructions for storage and use.
• Use single-use or single-dose vials whenever possible
• Always use a sterile syringe and needle/cannula when entering a vial. Never enter a vial with a syringe or needle/cannula that has been used on a patient.
• Cleanse the access diaphragm of vials using friction and 70% alcohol or other antiseptic. Allow to dry before inserting a device into the vial.
• Discard single-dose vials after use. Never use them again for another patient.
• If a multi-dose vial must be used, it should be used for a single patient whenever possible. The risk of transmission posed by inappropriate handling of multi-dose vials has been clearly demonstrated and mandates a practice of one vial per one patient whenever possible. Infection transmission risk is reduced when multi-dose vials are dedicated to a single patient.
• Keep multidose vials away from the immediate patient environment.
• Never store vials in clothing or pockets.
• Use filter needles to withdraw solution from an ampule.
• Never pool or combine leftover contents of vials for later use.
• Never leave a needle, cannula, or spike device inserted into a medication vial rubber topper because it leaves the vial vulnerable to contamination.
• Dispose of opened multi-dose medication vials 28 days after opening, unless specified otherwise by the manufacturer, or sooner if sterility is questioned or compromised.

• Assign glucometers to individual patients. Clean and disinfect glucometers if they must be reused between patients.
• Restrict use of fingerstick capillary blood sampling devices to individual patients.li>
• Use single-use lancets that permanently retract upon puncture. Never re-use fingerstick devices and lancets.
• Dispose of fingerstick devices and lancets at the point of use in an approved sharps container.
• Pen style devices with a removable lancet must be dedicated to one patient and lancets removed either by the patient or if by the healthcare worker with mechanical means (hemostat) to avoid finger contact.
• Thoroughly clean all visible soil or organic material (e.g., blood) from glucometer prior to disinfection.
• Disinfect the exterior surfaces of the glucometer after each use, even if there is no visible blood or soil, following the manufacturer's directions. Use an EPA- registered disinfectant effective against HBV, HCV and HIV.

Sterile Eye drops which are not contaminated by patient or other contact, are dated the date opened and discarded like any sterile injectable which has a preservative in a multi dose container. If used in the OR, if the circulator controls the eye drop container, and it never touches the field, the vial may be reused like any other multi dose Sterile Prep for 28 days after opening, unless the manufacturer places other restrictions on it - exp date or storage after opening. CONSULT with your pharmacy consultant before revising your practice/policy.

"It is crucial that everyone have a common understanding of what is meant by "flash" sterilization, since there have been technological changes that require a more nuanced understanding of this term.

Please refer to page 16 of the 158 paged document for the reference of "Reprocessing endoscopes" and the "Five Day" recommendation per AORN.