Re: Midline guidelines from AVA roundtable

[Gwen Irwin]

I would like to see midlines used more for appropriate patients, excluding the irritants, vesicants, etc.  I know we are all well versed in what is appropriate.  What happens for lab draws?  The INS states that midlines are not recommended.  What about the length of time for a midline to be in place?  Does the "data" support the INS standards?  Or do we just believe the standards and not question?   Given studies that define this niche of patients, we could proceed with knowlege that leads to better assessment of patients and advocate for midlines.  A midline would be faster for us to insert.  Given proven outcomes of midlines, I would use this info to lead to early, early assessment of patients in our community.   If there are people inserting a large number of midlines, they have information about who is the appropriate patient, what are the outcomes (completed therapy or not, with or without complications, etc), and about lab draws being successful or not.  Who knows what I am missing?   If this information is available and the outcomes reported, the standards could change.  I would advocate for INS standards to be changed based on evidence.  If there is a defined patient population of patients with known positive outcomes of having a midline to complete therapy, I would advocate for inpatient midlines.   Gwen Irwin Austin, Texas ----- Original Message ----- From: Heather Nichols To: Gwen Irwin ; Chris Cavanaugh ; [EMAIL PROTECTED] Sent: Wednesday, October 18, 2006 8:48 AM Subject: Re: Midline guidelines from AVA roundtable Chris,    I believe what Gwen asked for, and I would also like to see, was stats to show your success and how you collected that data.  Success should be documented also.  We collect all of our info on PICC's here.  I can tell you every success story as well as unsuccessful placements and why they were unsuccessful.  Also what we did to correct the problem, and what type of line the patient actually ended up with so that we do not make the same mistake in the future.   Gwen,    Correct me if I am wrong.   Heather Nichols RN BSN CRNI Infusion Services University of Louisville Trauma Institute 530 S. Jackson St. Lou. Ky. 40202 (502)562-3530 >>> "Chris Cavanaugh" <[EMAIL PROTECTED]> 10/18/2006 7:05 AM >>> I did not read anyone advocating for Midlines use in hospitals or anyone looking for the INS to change their guidelines.  Many of us succesfully use midline in long term care(nursing homes) and homecare within the INS guidelines.  Who would publish a study of lines being used properly??? -----Original Message----- From:  Gwen Irwin <[EMAIL PROTECTED]> Subj:  Re: Midline guidelines from AVA roundtable Date:  Tue Oct 17, 2006 9:53 pm Size:  3K To:  [EMAIL PROTECTED] Randy, I hear you about midlines being a viable choice for venous access.  I too believe that midlines have a place in our assessment of the patient that needs venous access.  I have a midline study approved by our IRB, but am unable to do the study, due to staffing and the manpower to complete it.  I have tried for 3 years to complete it without success.  Currently, w! e are not doing midlines.  That doesn't change my mind that they are a viable option. I have to challenge you to provide all of us that don't use midlines to SHOW US THE DATA!  If you have thousands without complications, please share the data.  Please publish your outcomes.  Don't defend their use, prove that they are an option!  Outcomes that you are supporting would be the change factor of current INS standards about midlines. I would love to see this information! Gwen Irwin Austin, Texas ----- Original Message ----- From: <[EMAIL PROTECTED]> To: "Alma Kooistra" <[EMAIL PROTECTED]>; <[EMAIL PROTECTED]>; <[EMAIL PROTECTED]>; <[EMAIL PROTECTED]>; <[EMAIL PROTECTED]> Sent: Saturday, October 14, 2006 6:32 PM Subject: Re: Midline guidelines from AVA roundtable > BS and Poppycock........................... > Tired of ! you people that continually make those that use Midlines feel > that they are bad practitioners. > > OK,  Put your money where your mouths are........   Show us how many > Midlines you have placed....  How many you have had that have had > complications.... and then show us your PICC Stats as well.  Show us.  I > have seen thousands of Midlines go a month without complication.  Give me > a reason to cross over!!! > Give me a reason to stop defending their use!!!!!  And give me your > proof..... > Not some article based on Bias.  An article not written by someone > associated with a particular Company such as Navigator or Sherlock that > wants every line placed to be a PICC so that they hawk their wares.  Show > me!!!!!!! > > Show me your Data!!!!!  And I will stop arguing for Midlines.  I know the > Standards so please don't send me those. > > You everloving Lightning ! rod. > Randy > > PS.  Alma sorry that it was your email responded too.  No offense to you. > > -- > Randy Ross R.N., B.S.N. > IV Nurse Consultant, > President & C.E.O. > IV's Etc...  LLC > Vascular Access >    & Consulting > Ph: 317-541-6463 > Fax: 317-894-7709 > Email: [EMAIL PROTECTED] > Website: www.IVsEtc.com > > -------------- Original message ---------------------- > From: "Alma Kooistra" <[EMAIL PROTECTED]> >> We generally refrain from placing a midline in anyone who has a potential >> of >>  >1 week of IV therapy, no matter how benign the infusate.  Personally, I >> think that anyone sick enough to need access >1 week probably should have >> a >> PICC.  That's pretty 'out there' I know, and that ! philosophy is not >> written >> in policy at my fac ility.  I just think it makes good sense, and since I >> insert nearly all of the lines it's pretty easy to enforce. >> >> Alma Kooistra RN, CRNI >> >> >> >> >> ----Original Message Follows---- >> From: [EMAIL PROTECTED] >> To: [EMAIL PROTECTED], [EMAIL PROTECTED], [EMAIL PROTECTED] >> Subject: Re: Midline guidelines from AVA roundtable --- message truncated --- Chris Cavanaugh,CRNI ----------------------------------------------------- Confidentiality Disclaimer This message, including any attachments, is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law, including PHI (Protected Health Information) covered under the Health Insurance Portability and Accountability Act (HIPAA) of 1996.  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. -----------------------------------------------------