I think this term applies to vein mapping especially when thrombosis is present in multiple veins of the arm. No vein status might apply if no suitable vein existed for fistula or graft. That no vein status would not pre-empt placement of a peripheral catheter since it is impossible to see inside any given vein without ultrasound or other aid, and as Lynn so eloquently stated, things change. This may be a policy we need to develop as more ultrasound assessment is employed with peripheral veins. Elizabeth, this No Veining appears to be something we need to discuss more!
Nancy Moureau, BSN, CRNI PICC Excellence, Inc. 888-714-1951 www.piccexcellence.com [EMAIL PROTECTED] -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Lynn Hadaway Sent: Tuesday, October 10, 2006 2:21 PM To: [EMAIL PROTECTED]; [EMAIL PROTECTED] Subject: Re: NO VEIN 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
