Hello everyone. I am pretty new here, but I need help. A couple of years ago our hospital disbanded the IV team. This past year we obtained a new DON. Her comments about IV teams consist of this "Every nurse should be able to do an IV." Unfortunately my director feels the same way. I know that it is important to shift our thoughts to patient satisfaction. Since the disbanding of the IV team the utiliziation of IV catheters has almost quadrupled. I work in the outpatient infusion center for the hospital and am told frequently all I do is IV's that there is nothing special about what I do. I have less than 1% inflitration rate and a 98% rate of getting IVs on the first attempt. (really I am not bragging, but I have 9 chairs and they are full over 60% of the time.) There is only myself RN, CRNI and an infusion tech.
First how can I approach my director and DON about a venous access nurse specialist. One to prevent patients with difficult sticks in receiving more than 4 sticks, make the DON aware that IV nurses are just as specialized as wound care nurses, and that placing PICCs on patients with certain diagnosis on admission will decrease the cost of the patient care.
I have probably upset my director who is WOCCN (certified wound and ostomy nurse) by this reply on many occasions. "If all nurses should be able to do IVs then they should be able to provided wound care."
Any help will be greatly appreciated.
Thanks,
Tina
There was a presentation at the recent INS meeting, second one on Monday morning but don't remember the name. It was about the value of the CRNI based on a survey. It might be helpful.
You will also need to document your value in financial terms. In 2001, the operational cost for starting a peripheral catheter was $32. Adjusted for inflation in 2007 dollars, that is about $37-38 now. So do the math to calculate the actual operational costs of what your hospital is actually spending on just starting PIVs. 4 sticks = $148 X 3 sites on a patient = $444. Find out the most frequently seen DRG in your hospital and learn how much your hospital is being paid for that DRG. Then calculate the percentage of that DRG spend on starting PIVs. I am betting it will be a high percentage and this is money that could be saved and directed to other aspects of that patient's care. Anyway, this is the type of financial analysis that the administration will pay attention to. This will work for inpatients but outpatients are billed differently.
Then there is the nursing assessment piece for choosing the most appropriate catheter for each patient early in their course of therapy so that extra expense is not seen on unnecessary and painful sticks.
Talk to your risk management about any lawsuits involving infusion therapy - infiltrations, extravasations, etc. How much did the hospital pay out? What can your team do to prevent that from occuring again.
What are your other complications rates? Enlist the support of your infection control dept.
But it all comes down to dollars. Good luck, Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Thank you Lynn. I am working on just that type of information right now. I appreciate the information.
Tina