midlines/irritants

Sat, 21 Oct 2006 18:27:45 -0700

Hello!  I am looking for articles/studies about Midlines and the outcomes of infusing irritants (ie.Vanco and Phenergan) through.
 
I would also like your expertise/experience regarding this practice.  If you wouldn't mind writing your response to these issues I would love to hear from you please include:
1.  name, credentials
2.  employment (where you work, ATU/outpatient settings, PICC   
team, IV team, home settings) and employer
3. what brand of lines you place, sizes, dual/single ALSO include where your "tip" resides ML and PICCs.
4. how you feel about using Midlines (or peripherals) to infuse these "irritants" or other irritants.
5. any negative outcomes?
 
I have just started at a new facility that repeatedly uses ML's for these medications.  I am completely against this practice as it is a patient safty issue along with being against INS (standards).  I am going to be approaching my managers and DON regarding their current practices.  I need evidence and best practice/expertise to bring along with me!  I plan on using any information that you all respond to, along with the INS standards.
Please assist me to help our patients and help change this poor practice!
Thank you in advance!
 
Candee Eisenhart RN, CRNI
Mercy Gilbert Medical Center
Gilbert, AZ
my home # 480-458-5028
cell 480-248-0376
[EMAIL PROTECTED]


Dianne Sim <[EMAIL PROTECTED]> wrote:
I agree with you Chris - Midlines are being utilized successfully (in most cases) in SNFs and home care! I would think the long-term care pharmacies and home care people would be the ones to encourage in these studies. The sad comment is that the nursing staff of most facilities are woefully under-educated in recognition of various lines and their care and maintenance. They also seem unaware of their legal liability when they assume the care of a patient with a vascular access device. As we all know, it gets back to education, and I believe this conversational thread will continue for many years until a formalized, universal, vascular access education is mandated in all nursing programs.
Aren’t soap-boxes fun!
 
Regards, 
 
Dianne Sim RN
CEO & President
 
IV Assist, Inc.,
2675 Appian Way
Pinole, CA  94564
Phone: (510) 222-8403
Fax: (510) 222-8277
Email: [EMAIL PROTECTED]
 
 
 
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-----Original Message-----
From: owner-[email protected] [mailto:owner-[email protected]] On Behalf Of Chris Cavanaugh
Sent: Wednesday, October 18, 2006 4:05 AM
To: Gwen Irwin; [EMAIL PROTECTED]
Subject: Re: Midline guidelines from AVA roundtable
 
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, we 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 facility.  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
 

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