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Changing VADs from outside hospitals

Hi Everyone,

Hoping everyone is saving their pennies for AVA/San Jose in October !

As part of our VAD management, (PIVs included) RN/MD staff were responsible to replace any PIV or CVC that came from an outside hospital within 24 hours OR 48 hours depending on the particular policy you read. Clearly this lead to confusion. Currently we are debating which time frame to abide by. How does your institution handle incoming (non-emergent/outside hospital) peripheral IV lines and CVCs ? AND what references are available that justify that practice ?

See you on the West coast in the fall....

Dave Bruce RN

Vascular Access Service

Albany NY

lynncrni
I would recommend a different

I would recommend a different approach. The CDC guidelines and now the INS standards state that any catheter inserted during an emergent situation must be changed as soon as possible or within 48 hours. The information about the conditions under which that catheter was inserted must become a component of the hand-off communication when the patient moves between units/services in a single hospital or between hospitals. If there was no emergent situation when the catheter was inserted and all proper techniques for skin antisepsis, etc were followed, there is no need to remove a catheter unless there is a clinical indication such as signs and symptoms of a complication. I have never seen any literature addressing routine changes of any catheter, PIV or CVC, based on a patient moving from one facility to another. The recommendations focus only on the conditions under which the catheter was inserted. They apply to all situations and are not restricted to pre-hospital vs in hospital or to a certain type of catheter (PIC vs CVC). They only address the situation at insertion. Think about the fact that home care companies, ambulatory infusion centers, and long term care facilities routinely accept the catheters placed by the transfering hospital and do not routinely change them. I think we have to pay more attention to this component in the hand-off communications.  Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

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