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Tara Dennis


I am in the process of updating policies where I work. One policy that I am trying to get approved is that of the having a MD KVO order where the MD has to specify the KVO rate in an order. INS standards are very clear on this, but my hospital would rather put a KVO rate in a policy. I know this would not meet the standards of practioce, but I'm currious to see what other hosopitals are doing to adress this issue at all & what your current policy is or what you are doing?

Thx for your feedback.


Hi Tara, I am also looking

Hi Tara,

I am also looking into updating (starting!) KVO policy at our hospital. I was thinking that we might write a policy that states that KVO must be part of a physician order, but that we could create a protocol so that physician order could read "KVO per protocol"

I would be interested to know what KVO rate your hospital is considering using, and WHY. I have been unable to find any research or evidence for rate determination. Our local infusion company uses 0.4cc/hr, but in-hospital KVO rates I am seeing range from 10-50cc/hr!!



Tara Dennis
HI, After speaking with the


After speaking with the INS education consultant about the standard on this, I was told that you really need to have a MD order, due to the fact that every patient's needs are different & what one patient may be able to tolerate for a KVO rate another may not. This makes sense & I actually agree with the standards.

 I haven't found any research or statements supporting a specific KVO rate, infact I've read articles that support the need for flushing even though there is a continuous rate infusing, becuase of the laminar flow not being enough to clear the vein & prevent clot/fibrin formation

The issue is getting the nurses to obtain a KVO order & the Doc's to write it. See at the hospitak that I work at this has been an independent nursing action so it's a really hard sell. It's looked at as going backwards.

Tara Dennis, RN,BSN,CRNI

Here KVO means an Infusor
Here KVO means an Infusor cap. If some-one wants a line left running, then the Dr needs to specify a rate. Having said that, if a pt is on so many meds that the pt barely gets unhooked and it's time to hook them up again, the nurse will use judgement and just run the IV slowly between meds. They are supposed to still have Dr okay that and order a rate tho.
I have also tried to find
I have also tried to find evidence supporting a specific rate for KVO and it is not known. There is no single rate that will maintain the patency of the catheter and/or vein. A physician's prescription without a rate is not a complete and legal prescription. 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

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