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The Effects of Saline Flushes on Taste and Smell Crystal Rice, BSN, RN Vanderbilt University Medical Center, Nashville, TN 37232 Background Results Hypothesis Methods Results Conclusion IV catheters are routinely flushed with saline to maintain IV patency, which is standard of care practice Some patients have experienced a taste and/or smell when their IV catheter is flushed with saline IV catheters are flushed with saline from a commercially prefilled syringe and/or saline from a multi-dose vial or bag depending on unit policy/procedure and/or nurse preference Commercially Prefilled Saline Syringes - Advantages: Allows nurses to be more efficient in their work flow Manufacture labeling increases patient safety Decreased risk of infection Decreased medication errors - Disadvantages: Can cause the patient to experience a taste and/or smell when their IV is flushed Some reports of infectious outbreaks have been reported due to poor compliance with the FDA’s quality system regulations and Good Manufacturing Practices Multi-dose Bags or Vials of Saline - Advantages: Cost effective Patients are less likely to experience a taste and/or smell when their IV is flushed - Disadvantages: Increased risk of infection 7.3 times more likely to experience a taste with the prefilled syringe when compared with the multi-dose bag (p<0.001 McNemar’s Chi-squared test) 10.4 times more likely to experience a smell with the prefilled syringe when compared with the multi-dose bag (p<0.001 McNemar’s Chi-squared test) 38 of the participants (77.6%) preferred the multi-dose bag of saline when compared with the prefilled syringe (p<0.001 McNemar’s Chi-squared test) Design: randomized, double blinded crossover study 49 participants were given three 10 ml injections of saline from a commercially prefilled syringe and saline from a multi-dose bag Each injection was separated by 30 minutes and given over 15 seconds Each participant received saline from both the commercially prefilled syringe and multi-dose bag At the completion of each flush the participants were given a questionnaire to evaluate their experience o Participants were asked to choose which injection they preferred Prefilled saline syringes will cause the patient to experience a taste and/or smell after their IV catheter is flushed with saline. Prefilled saline syringes cause the patient to experience a taste and/or smell after their IV catheter is flushed with saline. 16 4 3 2 1 1 1 14 8 1 1 6 1 5 Metallic Alcohol Bitter Chemical Sweet Salty Other 0 2 4 6 8 10 12 14 16 18 Recordings Taste Smell The participants description of the taste and smell for the prefilled syringe *Extra text 1 6 7 2 3 1 2 0 0 1 2 2 10 4 6 1 3 2 1 1 0 2 4 6 8 10 12 1 2 3 4 5 6 7 8 9 10 Recordings Intensity Ratings for the prefilled syringe 0 being no taste or smell detected and 10 being the worst taste or smell detected Taste Smell The participants rated the intensity on a scale of 0 to 10 0 5 10 15 20 25 30 35 40 Prefilled Syringe Multi-dose Bag 11 38 Number of participants who prefer the prefilled syringe versus the multi-dose bag 0 5 10 15 20 25 Prefilled Syringe Only Multi-dose Bag Only Both 20 2 2 21 8 8 Number of participants who experienced a taste and/or smell when their IV was flushed with saline Experienced Taste Experienced Smell Acknowledgements: Christa Hedstrom, EdD, RN, CCRP; Nancy Wells, DNSc, RN, FAAN; Vicki Sandlin, MSN, RN, CCRP; Kathy S. Moss, MSN, MBA, RN, PMP, NEA-BC; Lana Howard, BSN, RN, CCRP; Deloris Lee, BSN, RN, CCRP; Mary Gwyn Bowen, RN, MA; Daniel W. Byrne, MS; Li Wang, MS; Clinical Research Center Nursing Staff. This project was funded by VICTR (VR 1908), and in part by grant UL1 TR000445 from NCATS/NIH. The survey tool that was used was REDCap.
