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Efficacy of normal saline solution versus heparin solution for maintaining patency of peripheral intravenous
1Emergency Department, Children's Hospital, Denver, Colorado, USA.
Insights
Normal saline solution effectively maintains patency in pediatric peripheral intravenous devices, offering a safe and cost-effective alternative to heparin flushes. This approach reduces risks and saves significant nursing time and institutional costs.
Area of Science:
- Pediatric Nursing
- Intravenous Therapy
- Pharmacoeconomics
Background:
- Limited data exist on maintaining peripheral intermittent intravenous infusion devices (PIID) patency in pediatric patients.
- Normal saline is commonly used in adults, but its efficacy in children requires further investigation.
Purpose of the Study:
- To evaluate the efficacy of normal saline solution versus heparin flush in maintaining pediatric PIID patency.
- To determine the cost-saving implications of using normal saline compared to heparin for PIID maintenance.
Main Methods:
- A prospective, randomized, double-blind controlled trial was conducted.
- 77 pediatric patients received heparin flushes (control), while 73 received normal saline flushes (experimental).
- Standard hospital flushing protocols were followed.
Main Results:
- No significant demographic or complication differences were observed between the groups.
- Annual cost savings were estimated at $27,594, with savings of $9.45 per procedure.
- Normal saline demonstrated comparable efficacy to heparin in maintaining device patency.
Conclusions:
- Normal saline is an effective alternative to heparin for maintaining pediatric peripheral i.v. devices.
- Using normal saline eliminates heparin-related risks and reduces infection potential.
- Significant cost savings and decreased nursing time are realized, allowing for improved patient care.
Objectives:
Literature reports support the use of normal saline solution for maintaining patency of peripheral intermittent intravenous infusion devices (PIID) in the adult population; however, there are limited data regarding this policy in the pediatric population. The purpose of this study was to establish the effects of heparin flush and saline solution flush solutions in maintaining patency of infusion devices in the pediatric population, and to establish cost-saving implications related to both procedures. The specific aims of the study included the following: (1) to determine the efficacy of normal saline solution flush for peripheral i.v. access devices for the pediatric population, and (2) to establish cost-saving implications related to normal saline solution versus heparin flush for PIIDs in terms of pharmacy costs and costs related to nursing time.
Methods:
The study was a prospective, randomized, double-blind controlled trial of flushing solutions. The control group (n = 77) received 3 ml of a 10 units heparin/ml normal saline solution i.v. flush. The experimental group (n = 73) received 3 ml of normal saline solution only for the i.v. flush. Routine hospital procedure for flushing was followed during the study period.
Results:
Descriptive and correlation statistics were used to analyze the data; chi 2, t test, and analysis of variance were calculated. There were no significant differences between the two groups for demographics or complications. Annual cost savings were computed for both procedures with an estimated annual savings of nursing time and unit cost of solutions equaling $27,594. The savings per procedure was estimated at $9.45.
Discussion:
This study provided support for the efficacy of normal saline solution as an alternative to heparin solutions for the maintenance of peripheral i.v. devices. Implications include elimination of risks associated with heparin (drug incompatibilities, thrombosis syndrome, hypersensitivity reactions, local tissue damage, and iatrogenic hemorrhage); decreased potential for infection associated with breaks in the integrity of the i.v. system; substantial money savings as a result of the change to normal saline solution realized by the patient and the institution; and decreased nursing time. By simplifying the procedure, nurses have more time to provide aspects of nursing care to patients.