Nurses have always been the patient’s advocate at the bedside. In all we do, our responsibility is to the life and well-being of the patient. We live by the ethical principle of nonmaleficence: “to do no harm.”  

Nurses are the end users of nearly every tool and medical device on the market. They are the masters of the interface between machine and patient. We assume that the devices and tools we use on our patients are safe and effective—that these tools adhere to the same standards that we hold ourselves to: “to do no harm.” 

This is why I had such a visceral reaction to learning about the toxic, synthetic chemical Di(2-ethylhexyl) Phthalate (DEHP) being widely used in IV bags across US healthcare settings—even after the chemical was banned in the US from children’s toys in 2008.

Putting patients at risk

DEHP is known to be a highly toxic endocrine disruptor and is linked to a host of devastating health issues. This includes reproductive issues, such as decreasing sperm production and fertility in males, increased birth defect rates, and altered puberty timing. Kidney and liver damage are also possible.

DEHP is a documented carcinogen, which is why Breast Cancer Prevention Partners took such a strong stance in supporting California Assembly Bill AB 2300 to phase out the use of DEHP in IV bags.  This bipartisan legislation, which was signed into law in September 2024,  provides the best hope of forcing the medical device industry to take action and remove this toxicant from our IV bags. 

The nursing knowledge gap

As a nurse, a question lingers in my mind: how many patients have been harmed by the very tools we were given to provide the necessary medications our patients needed—in this case, IV bags — while at the same time, exposing them to DEHP and potentially causing them a serious health issue in the future? 

But the truth is, we just didn’t know.  And it seems that many nurses still don’t—according to a recent survey of over 500 nurses and other healthcare providers by The Nursing Beat, 74% of respondents were unaware that DEHP was used in IV bags. However, after learning about it, 98.5% of those surveyed would prefer to use bags that do not contain DEHP.  

Advocating for a safer healthcare environment

The truth is, it is time to prioritize patient safety and remove DEHP from IV bags. There are new and better solutions on the market, such as IV bags made with polypropylene and polyethylene, which don’t require DEHP. 

When I spoke with Stephanie Pitts, one of the leading nurse experts in the medical device industry and the Vice President of Strategic Planning and Initiatives at B. Braun, she explained that more than 40 years ago, B. Braun recognized the environmental and patient risks posed by medical products containing DEHP. B. Braun does not manufacture IV Bags made with DEHP. It is time for the rest of the industry to follow.

As nurses, we must use our knowledge, expertise, and role as the patient advocate to demand action in phasing out the use of DEHP in medical products. By supporting California bill Assembly Bill 2300 and similar legislation in other states, nurses can positively affect change—not only for our patients, but for the entire future of the medical device industry.  

When nurses speak, others listen. We have always been passionate about the health and safety of patients above all else. Let us pave the way toward a safer future for our patients by eliminating the use of DEHP in our IV bags.

‍

This article is sponsored by B. Braun.