I am wondering what other facilities are doing to assess CVL's and the documentation process.
Our PIV infiltration/extravasation scoring tool is attatched to our CVL assessment in our EMR. When scoring any redness this indicates an infiltration. When there is redness at the CVL insertion site it does not necessarily mean there is an infiltration, a concern yes, but not necessarily an infiltration. Wondering how to document redness at a CVL site without indicating an infiltration? I am also interested in the process and documentation of line functionality.
I am reaching out to others to see what process is being used to assess CVLs.
-Is there an assessment tool specifically gearded toward CVLs?
-Ho w often is a CVL assessed and documented in the EMR?
-What is included in your assessment of a CVL, functionality?
-What is your policy for CVL functionality? How often and specifically is this assessed?
-Do you document this assessment in the EMR?
- Does this process differ if the CVLis helparin/saline locked vs. infusing?
Appreciate any feedback on the questions asked.
Thank you
Redness at a PIV is not a first sign of infiltration either. It may occur but it could also be blanching. Don't understand your scoring tool tying PIC and CVADs together. There are several infiltraiton scales in the published literature but only one in peds has been tested for reliability and validity - see INS Standard for this info. Functioniality of all VADs, PIV and CVAD, must be assessed and documented before each infusion. Includes looking at it, palpating, aspirating for blood return, flushing for resistance, assessing the entire system. No difference based on locking solutions. This documentation is critical when an expert must assess a medical record in a legal case. The major unasnwered quesstion is for continuous infusion - how frequetly to do this complete assessment. Depends on type of fluid infusing - vasopressors could not be stopped, etc. I commonly see absence of this documenteation when I review medical records in a lawsuit. This means I may not be able to support the nurse in the decisions made and action taken. 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