Our attorney adivises us the TKO is not a legal order. A rate needs to be attatched to this order for it to be a legal order.
That is exactly correct. A KVO or TKO rate is not a legal order as there must be a rate specified for each patient. I also do not understand the need for any slow KVO rates. First there is no such rate that is scientifically shown to keep open any vein or catheter lumen. Second, if the patient does not require a specific amount of fluid, why not just cap the lumen and use it intermittently, thus allowing the patient more freedom of movement and a quicker discharge from the hospital.
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
Robbin George RN VA-BC
There is no evidence that this low flow rate helps to maintain catheter patency, however I can understand the need to piggyback a PCA or multiple medications into an infusing line. I have seen hospital policy make an attempt to write a so-called KVO rate, but there is no science to back it up and it ignores the individual patient needs. I do not think it is an acceptable method for addressing this. All orders must include a rate specific to that patient written by the physician or NP with prescriptive authority. Lynn