I write policy and procedure for our vascular access team. My manager does not feel that the language in the INS Standards of Practice (Standard 44 C. ) would be respected by a JACHO audit. This is the section that refers to PIV's inserted under Sub-optimal conditions. She would like our policy to have all "field starts" replaced. I can find no Evidence to support this view. Does anyone have some evidence that I can quote?
Thanks'
Donna Pagel RN, CRNI
Vascular Access Team
St Charles Medical Center Bend OR
This language was changed because this situation does not only apply to any VAD inserted in the "field". It applies to any VAD, peripheral or central, inserted when the appropriate and complete aseptic technique cannot be used. Any cardiac arrest situation comes to mind. No time for hand washing, correct skin antisepsis, max barriers, etc. Thus the aseptic technique is suboptimal due to the fact that saving the life takes priority. "inserted under emergent conditions" is a phrase used in old CDC guidelines. So broaden your thinking on when and where these situations occur. It is not just paramedics inserting a PIV at the scene of an accident. It can easily be on your med-surg unit or outpatient or ER. 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