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I think this is a reasonable policy that will promote patient safety. I would even go so far as to remove the part about one being done in the past 2 weeks. We have had discussions about this at our INS chapter meetings and most hospitals represented automatically repeat chest xrays on every patient coming in the door with an existing catheter of any kind. There are several reasons. Activity can lead to catheter tip migration, thus you would be infusing into the IJ or contralateral subclavian. Also, some home care companies continue to place midclavicular catheters, even though we know they are not recommended. Once inside the hospital, you could receive orders for any number of fluids that requires infusion only through a properly placed tip in the SVC. It is far better to know where that tip is before you infuse anything. Lynn