RE: Midclavicular catheters

[Dianne Sim]

We are fortunate that the SNFs in our area are generally savvy enough to know that the selection of the correct vascular access device is not a "choice", but is mandatory in our oath of "DO NO HARM". I believe we must constantly encourage the administrators to do the right thing, while working to change the political system governing our practice, so that the very best is received by everybody, every time. You are right Lynn – they must do “what they need to properly care for the patient”(as per Chris C). I can’t believe the SNF patient population, and/or their families, would be willing to allow the administrators to take the risks we are talking about if they were properly educated/informed in the issues. Regards, Dianne Sim IV Assist, Inc Pinole, CA   -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] On Behalf Of Lynn Hadaway Sent: Friday, March 17, 2006 8:26 AM To: [EMAIL PROTECTED] Cc: VICTORIA SALLESE; [EMAIL PROTECTED]; [EMAIL PROTECTED] Subject: Re: Midclavicular catheters   Ahh, but your last statement is the point. They can not properly care for a patient receiving drugs through a midclavicular line. Most thrombosis will be clinically silent but still be doing the vein damage. So the nursing home is accepting a situation that is impossible to manage safely. Sure wish all of them appreciated these risk. Lynn   At 11:18 AM -0500 3/17/06, [EMAIL PROTECTED] wrote: >My experience is in Florida homes only.  There are many factors that >play into this scenario, first and foremost--PPS.  LTC facilities >are also under pressure from Medicare (with 100 day limits for post >hospital care) and insurance companies to get their patients out >quickly, which does leave empty beds.  Many times, as the local >hospital is full, so is the facility, if hospital census is low, so >is the facility.  Sure, in some cases families have input as to >which facility the patient goes to, but they often rely on the >recommendation of the discharge planner at the hospital, who has a >relationship with one or two LTC facilities. Also, proximity plays a >role, if the family is involved, they want mom or dad close to home, >which is usually close to the hospital they were in. No matter how >the referral gets to the facility, pt, family or D/C planner >recommendation, the LTC facility will not spite its revenue stream >by saying NO.  Those decisio! ns, when >  >Most facility DONs will take whatever....then call the pharmacy or >hospital to get the training or equipment they need to properly care >for the patient. >  >Chris Cavanaugh, CRNI >  >----- Original Message ----- >From: Lynn Hadaway <[EMAIL PROTECTED]> >Date: Friday, March 17, 2006 11:07 am >Subject: Re: Midclavicular catheters >To: VICTORIA SALLESE <[EMAIL PROTECTED]>, [EMAIL PROTECTED] >Cc: [EMAIL PROTECTED], [EMAIL PROTECTED] >  >>  I had always known that home care was as Chris described but I >>  always >>  thought that LTC had more control over who came in their doors. >>  With >>  the aging of America and the demand for skilled nursing home beds, >>  I >>  really do not see that nursing homes must cater so strongly to the >>  demands of referring physicians. In fact my mother has been in 3 >>  different nursing homes now and the physician was not involved in >>  making an! y of thos     -- Lynn Hadaway, M.Ed., RNC, CRNI Lynn Hadaway Associates, Inc. 126 Main Street, PO Box 10 Milner, GA 30257 http://www.hadawayassociates.com office 770-358-7861