First, I have never seen or used this concept of labeling a patient
as No Veins.
A patient may present with no peripheral venous access today due to
fluid volume deficits, a catheter is placed in the AC to get in some
fluids, then a couple days later has several peripheral sites
available. So this can change from day to day.
If a patient has a long history of IV therapy and truly has extremely
limited peripheral sites for IV access, then your team would need to
be proactive about getting some other type of catheter inserted -
midline, PICC, other central line. To identify this situation and
continue to try to obtain peripheral access would subject the patient
to unnecessary pain and trauma and significantly drive the costs up
for your facility.
The criteria for using a short peripheral catheter as the preferred
type of catheter include:
1. therapy that will be required for less than a week
2. therapy with a pH between 5 and 9
3. therapy with a final osmolarity less than 600 mOsm/l
4. no vesicants
5. sufficient peripheral venous access sites to manage a week of therapy
If the patient does not meet these criteria, another type of catheter
should be chosen. If this happens, your problem goes away. The idea
is the right catheter for the right patient at the right time or the
catheter with the greatest likelihood of delivering the entire course
of therapy with the minimum number of catheters used.
Lynn
At 9:19 AM -0400 10/10/06, [EMAIL PROTECTED] wrote:
1) Does anyone have a Policy and Procedure (or thoughts on) regarding "No
Veining" a patient? What criteria do you use to decide a patient has no
peripheral venous access? When do you reevaluate the patient, if a central
line has not been placed? What do you document?
2) If you have documented that a patient is "N/V" and someone else comes
behind and places a PIV, what are the legal ramifications? How do you
prevent other staff from overriding the IV Teams expert opinion for "no
veining" the patient?
Thank you....
Elizabeth A. Raucci, RN, MSN, MHA, OCN, CNS
ADMINISTRATIVE MANAGER: IV Services
MANAGER: Dialysis and Apheresis Contracts
Phone: (203) 855-3891
FAX: (203) 855-3893
Beeper: (203) 831-7593
--
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
