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TerryF
IVDA and potential to tamper with lines

Hello All,

We just started using the Neuma clamp on a pt. with hx of IVDA, whom happens to be popping up with multiple CLABSI's while in the hospital. I need to write a policy and wondered if there are any handy out there?

 

Thank you,

Terry

mary777
We are going to try this

We are going to try this device and I was just going to add the information to an already exsiting CVAD policy. I do not think it is necessary to write an entire policy on the use of the device. 

  • Use anti-tampering device on all central lines  placed on patients with current history of IV drug abuse
  • Follow manufacturer's IFUs for the product used. 
  • Obtain signed wriiten contract from the patient agreeing to avoid the use of their central line for illict IV drug use  
lynncrni
The phrase "anti-tampering"

The phrase "anti-tampering" sounds like this device actually prevents someone from opening it. It simply makes it obvious when someone has opened it but does not prevent tampering. I have always wondered what actions are taken when tampering is found. What should the nurse do when they find the device open and know they did not open it? 

 

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

TerryF
Action to take when line has been tampered with

Hi Lynn, 

Our policy will state-Tamper detection device-A tamper evident/deterrent device is intended to be used as an accessory to vascular access lines as a means of lessening the risk of unwanted flow through the line to help safeguard against accidental overdose and risk for CLABSI. The device may be utilized for patients with a history of IV drug abuse, or other evidence of tampering. Staff may initiate the device and then contact the Clinician to collaborate a plan of care to include the use of the tamper-evident device. The clinician will order the device to be used when the patients' line is not in use. Should the patient refuse the device then notify the provider. If the device has been tampered with contact the provider immediately.

The provider may choose the best direction at that point; they may decide to place on a 1:1 monitor, or DC IV if able.  

 

lynncrni
Thanks!   

Thanks! 

 

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Gina Ward
Terry,

Terry,

How is this working for you?      I am curious as this is an issue everywhere.

I also read your statement about initiating this to avoid accidental overdose, and to be initiated when line is not in use.  I was thinking the main reason is to protect the pt from acquiring a CLABSI from misuse of the line, but I totally understand the potential for overdose in a device that we inserted and a liability in the situation of these high risk pts.   Do  you address misuse or pts self injecting?

Are you using this on all pts then?  or just the high risk  known IVDU ?  are you sending pts home and using these on an OP basis?     Have you encounterd any tampering? 

I am thinking some of these pts might even just try inserting the needle into one of the lumens itself instead of the  actual access point that we use??   

I look forward to hearing  how this is going for you. 

Someone also mentioned having the pt sign a contract, is anyone doing that?  I would love to see an example of the contract and the policy component that addresses that as well.

Thanks Gina Ward R.N, VA-BC

Gina Ward R.N., VA-BC

lynncrni
Michelle (Mickey) Hawes from

Michelle (Mickey) Hawes from Indiana is the preeminent expert on these issues. Look for presentations, publications by her on this topic. 

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Gina Ward
Will do, Thanks,

Will do, Thanks,

Gina Ward R.N., VA-BC

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