|
Thank you Ann for your response. We are privately owned, no hospital
affiliation. We have a hard time convincing case managers and discharge
planners that this is important for us to have before admission. As far as the
Oncology nurses, It surprises me that They are not concerned. We hook up the 5FU, but they’re giving the “Big
Boys” there. They joke in front of the patients about how particular we are.
Isn’t that a GOOD thing when it comes to patient care? I don’t get it. We don’t
want to loose this account, but patient safety has to come first. Do you or
anyone out there have a policy I could look at? Thank You so much Brenda -----Original
Message----- Yes,
Brenda, we do require a tip placement verification before we begin
therapy. We are fortunate in that most of ours come from our
"mother" hospital and I can view the results in the computer.
Our referral nurses are good about copying the report from the chart when they
are gathering the chart parts. Your
beginning statement sounded like it was written by me! (The 5-FU
patients). But I haven't heard any problems from our nurses. So either
there is no problem, or they are ignoring it, in which case I will have to hunt
them down and hurt them!! :) I think, like you, I would also want
to see the report. If I
can be of any help, let me know. ann Ann Williams
RN CRNI From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On
Behalf Of Brenda Seaver -----Original
Message----- I was wondering if
anyone has a policy they would be willing to share on validating line placement
or usability. We are a home infusion company. We have many patients that we
hookup to 5FU via a CADD prizm for 48 hour continuous infusion at an Oncology
suite after their chemo there. These patients all have accessed ports when we
get there. Our nurses flush, check for patency, and hooks up pump, then we see
patients 2 days later for disconnect and deaccess. Problem is we’re finding
many patients don’t have a blood return when we go to hookup. We have been told
there OK to use by MD, they flush easily, some say studies have been done –but
we have no report to back that up. We are seen as a nuisance when we push for
studies. We don’t want to take chances with our patients like this. Lately we
have been reaccessing (which of course the patient hates-another stick), then
we tpa, Chemo hookup is delayed and everyone is upset. One patient still had no
blood return, we were told studies were done, ports OK, unable to find report?
What do we do? Our Nurse Educator and myself have scheduled a meeting with the
office manager, I want to go in there with a good policy. Please help; I learn
so much from all of you. One more question, when a new patient comes on service With Central line do you all require placement
reports before infusing? Again we are home infusion. Thank you so much Brenda -----Original
Message----- Our hospital is
considering trialing Ethanol locks - there is a debate about the fill volume to
use - will be used in PICCs, tunneled and non-tunneled lines as well as some
dialysis catheters. They want to keep it standardized as much as possible
for adults. They will also be using it in the peds population. I
have done some limited research but I would like to hear what others have to
say. Thanks Ann Marie ----- Original Message ----- From: Heather Nichols
To: Listserv, IV ;
Peng, Kathleen Sent:
Wednesday, May 24, 2006 1:16 PM Subject: Re: FW: Need article references Kathleen, We just put a policy into effect on your number
one question. We evaluate tip location on any line that comes in house
for use. It does not matter what type of line it is. We had an
issue just last week where a man came in for chemo and said he had a
PICC. It was barely a mid-line, and the man was to get Vinchristine
What a disaster that could have been. Our policy also reads that a
central line of any kind must have a good blood return and flush easily.
If not, we can tPA, by either stop cock for solid occlusion, or drip for no
blood return. If the tPA does not work, the patient is to go for a dye
study in IR to find out what is wrong with the line. IR, and the
primary team has final say. We use stop cock to avoid putting too much pressure
on the line, and the ability to agitate the clot slowly. Hope all is going well with you guys! Heather Nichols RN BSN CRNI From: Peng, Kathleen I was just asked by one of our educators for some input on two of
our policies that are being worked on: 1). Central Line Care: need for initial CXR on a pt that is
admitted with a CVL already in place (PICC, Jugular, Subclavian) Currently, it is not actually in our policies that a CXR NEEDS to
be done prior to use but we have educated staff on the need in the case of
PICCs. What is everyone else doing and what are your references to support your
practice? 2). Obstructed Catheters/Use of TPA Currently our policy just basically states to use TPA 2 mg, let
dwell, etc. The question is whether to use the stopcock method or hook the
syringe directly to to the lumen. We have been instructing to just hook the
syringe to the lumen and it has been working well. What are others doing? Are
there references out there to support one practice over another? Thanks, Kathleen Witt, RN, BSN Nutrition Support Presbyterian Hospital of Dallas 214-345-7468 [EMAIL PROTECTED]
If you are
not the intended recipient(s), you are notified that the dissemination,
distribution, or copying of this message is strictly prohibited. If you receive this message in error,
or are not the named recipient(s), please notify the sender or contact the
University of Louisville Health Care I.S. helpdesk at 502.562.3637 to report an
inadvertently received message. -----------------------------------------------------
|
- RE: fill volumes, Blood Returns Ann Williams
- RE: fill volumes, Blood Returns Brenda Seaver
