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Chris Cavanaugh
Drug addicts with Central lines--Suggestions, please

Team, I recently had a hospital ask me the following:

Chris- do you know, or could you ask on the list serv how drug addicts are being handled?  We have had a rash of drug users manipulating and inappropriately using their lines resulting in infections.  We were wondering how other hospitals manage this problem. 

 

Certainly, these patients need to be closely monitored and transitioned to PIV and oral medications as soon as possible, but in the mean time, how do you handle this in your facility?

Thanks for your input.

lynncrni
Are they asking about manaing

Are they asking about manaing inpatients with drug addictions who are having drugs sereptiously brought into the hospital? Or are they asking about sending these patients into home care with some type of CVC? It seems the risk would be the same or very simlar for a CVC and a PIV - both would provide venous access for illicit drug injection. I do remember many years ago there was an article in JVAD about a negotiated contract between the home care company and these patients and how they managed these types of patients but can't recall the reference information. It was from the late 1990's though. 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

Saharris
Drug Addiction

The clinical treatment of these patients as far as the need for PICC lines is no different than any other patient. If they need a PICC then they should get a PICC, and to do otherwise could actually put a facility in legal jeopardy.
It would be prudent to document patient understanding of the risks of infections, and perhaps even sign a behavior contract, which hopefully your facilities social worker could assist with.

Stephen Harris RN, CRNI, VA-BC
Chief Clinical Officer
Carolina Vascular Wellness

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