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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 Sent: Thursday, June 08, 2006 11:25 AM To: Brenda Seaver; ann marie parry; Listserv, IV; vascular Subject: RE: fill volumes, Blood Returns 
-----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]
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- RE: fill volumes, Blood Returns Ann Williams
- RE: fill volumes, Blood Returns Brenda Seaver
