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Mary Raap
Doccumentation of IV therapy

We recently had a group formed that was to come up with a new IV doccumentation form for our 5 hospital system.  One of the members of our group, who has a long history of being an infusion nurse, said that it is going to be a JACHO requirement that the exact vein is named where a peripheral IV is placed/attempted.  I have not been able to find any data to support that (but am not denying that it exists). If so, does anyone know about these changes?  We do not want to create a new form, only to have to create it all over again when these mandates come along.  Also, does anyone have a reliable doccumentation tool that they use to doccument attempts and successful IV insertion sites that you would be willing to share?  It has been a difficult search to find diagrams that show all views of the hand and arm.  If you do use such a tool, is it used with computerized doccumentation?  Thank you in advance for any and all assistance.

                                  Mary Raap, RN 

                                  San Antonio, TX          

I am not aware of what JCAHO

I am not aware of what JCAHO will do in the future, however the INS standards of practice 2006 strengthened the language on documentation of the site. In addition to a long list of other facts in the documentation standard, it states "Identification of the insertion site by anatomical drscriptors, landmarks, or appropriately marked drawings."

The concern of the committee was that a vein name alone would not be sufficient. You can stick the cephalic vein slightly above the thumb, anywhere in the forearm, antecubital or upper arm. So simply charting cephalic vein is not sufficient to adequately indicate exactly where the catheter was located.

 From  reviewing medical records as an expert witness, I can attest to the fact that IV sites are not adequately documented as to the exact location. Another problem is indicating which meds were infused through which site when there are multiple sites and the standards committee added this also. 

Sorry, I don't have an acceptable form to share, but I would encourage you to follow the list of information in the INS standards as this is the legally authoritative document to which your nurses in all settings will be held accountable. Their documentation can help or hurt them in a legal action. Lynn 

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Mary Raap
Thank-you Lynn for your
Thank-you Lynn for your information.  We find that we have difficulty just getting some nurses to identify the correct arm that they are using, let alone which vein it was.  In your expert opinion, do these diagrams of the arms need to show the vessels and their names, or is it enough to have pictures of external views of arms and have them mark the location of venipunctures on that?  We are also looking into the issue of doccumenting what medication was infused through which site with mulitiple lines.
I am really looking for

I am really looking for research or information about nursing which is specialised at I.V. therapy studdy, so if you have any theory information please send it to me by E-mail to [email protected]

Best Regards,


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