Wondering if anyone would share what their hospital P & P is for checking blood returns on CVAD's. I have read what INS standard is but that can be left open when you talk to floor nurses whose patient has a continual infusion and they do not check blood returns as long as the pump does not alarm. I would like to get feedback from others as to what is the current practice for lines that have both intermittent and continual medications infusing.
I do not have a policy to share, however I would like to share a recent issue of a newsletter that addresses one thing you mentioned. Nurses have a serious misconception about the purpose and capability of infusion pump alarms. There is nothing about an infusion pump that can provide information about where the fluid is actually going. Therefore the occlusion alarms should never be viewed as a reliable indicator about the patency of the vein or catheter. For blood return, I would recommend that it be assessed prior to the administration of each medication just as the standard states. This does leave open the question of how frequently should it be checked when there is only continuous infusion and I would very much like to know how others have addressed this in P&P.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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
Lynn,
We require our nurses to check all lumens for a brisk blood return on each shift. If there is a continous infusion we quickly check that lumen by accessing the port closest to the patient. Often this check can be done when administering a medication. The patency of each lumen is documented on each shift.
Barbara Tinsley