Can anyone give me feedback on any guidelines they are aware of regarding limiting the number of PIV attempts to one per practitioner. I have been told this is a new CDC guideline but I have not been able to find it. I know INS states 2 attempts per person. Thanks, Holly
Our health system policy is 2 attempts per practioner
ann marie
Holly,
Our institution follows INS. However we do take into account anything the CDC recommends. I am not aware of this CDC recommendation. Which CDC publication are your referring to?
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
2 per nurse and after 4 attempts I place a midline. A IV start is around 25$, so after 4 times you are in a price range from a ML, try more and you have a paid PICC.
Andre
I like the idea of two per patient and not two per practitioner
INS says two per practitioner, CDC gives no recommendation
That means a patient can get stuck an unlimited number of times as long as you use multiple practitioners. Stupid recommendation in my book. I think there has to be a stopping point. Maybe INS should change this recommendation to two per practioner with a maximum of four atttempts and than an MD recommendation must be made.
Kathy Kokotis
Bard Access Systems
Our hospital policy is 2 attempts per IVRN, 4 total and then notify the MD. We don't stick just to say we tried- if one IVRN tries once and isn't comfortable with a second attempt, she'll call a second IVRN, and if the second IVRN looks and says no, we stop there and request MD intervention. I would like to see a policy developed that mandates use of ultrasound after the first missed stick. What a concept!
Leah Calicoat, RN, CRNI, OCN, ACRN
Daniel Juckette RN, CCRN
I work in a 50 bed community hospital. Doing ultrasound guided peripheral IV's is one of the ways we maintain the skills of our PICC Nurses. We allow 2 sticks in the ER and 1 on the floor before calling for ultrasound guidance. We have seen significant improvement in our patient satisfaction surveys since initiating these guidelines. It is not fair to any practitioner to be forced to de-escalate a patient who has suffered through repeated failed attempts before you even walk in the room. Additionally, notifying a PICC nurse of a difficult stick usually triggers a dialogue about what is really the appropriate access device for this patient's hospital stay.
Daniel Juckette RN, CCRN, VA-BC