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Jeannette Andrews
First doses of antibiotics

I just ran into something I have never heard of!  An ID MD wrote an order for a patient to have a PICC line inserted and to have her first dose of Ceftaz prior to discharge.  I went to see the patient at 8 am this morning for the PICC insertion and was asked to return after 12:30 pm once surgeon saw the patient (request was per the patient, her daughter and the surgeon).  So the primary RN gave the patient her first dose of Ceftaz at 9 am peripherally without incident.  I placed the PICC at 1 pm as requested.  The home health care intake nurse came up to see the patient at 3 pm and stated that she HAD to have the first dose of the Ceftaz THROUGH THE PICC LINE before she could be discharged!  Well, the Ceftaz is q 24 hours and she isn't due again until tomorrow at 9 am.  So the HHC nurse said that the patient couldn't be discharged home until she received the dose through the PICC in the AM!  I asked the rationale for this and she said "it's the policy".  It is my understanding that the first dose is given in the hospital setting just in case there is a reaction-it doesn't matter if it is infused peripherally or via any other line.  The PICC has a spontaneous blood return, flushes without resistance and was confirmed in the SVC per the radiologist.  They still insist the dose must run through the PICC before they will take her.  Does anyone out there have this policy-if so why???  Thanks!

 Very strange policy, never

 Very strange policy, never heard or seen such a policy either. I can not think of any good reason for this. I am wondering if this HHC nurse simply does not understand their policy. Have you contacted the HHC intake coordinator or DON to validate this information? Lynn

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Jeannette Andrews
Thanks Lynn, that is what's

Thanks Lynn, that is what's happening at the moment!  I appreciate your help-didn't know if I was missing something here!  :)


Jeannette Andrews, RN, CRNI, VA-BC

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