The length of dwell is not the issue. Being able to adequately observe the insertion site and the catheter's tip for infusion related complications is the issue. You see the site through the gauze dressing, so I would say this is less than the ideal situation. There are always 2 steps to be considered - catheter stabilization and catheter site dressing. I see lots of legal cases commonly from ER or non-acute care infusion settings where there has been no attempt to properly assess the site before giving a vesicant med such as promethazine. Gauze and tape is an acceptable dressing, but it obscures visualization of the site, so it is not the best choice in my opinion. Site selection away from areas of joint flexion is a huge issue in these settings as most complications occur in the hand, wrist or AC. Catheter and joint stabilization are never documented in these settings so it is very difficult if not impossible to determine that the nurse did meet the standard of care. 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