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pressleystillwater
Physician order to access
If a physician writes orders to start IV fluids and the patient has an implanted port or other Central line do you need a specific order to access the line or do you just go ahead and access without a specific order?  Any help would be appreciated.  Thanks
lynncrni
This depends upon your
This depends upon your hospital policy and this is primarily written based on the specific preferences of the physicians with patients that have implanted ports. I have always worked where we could use it without a specific order. We figured it was placed for infusion therapy, so an order for infusion therapy meant we could use it. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Nadine Nakazawa
We allow staff nurses to
We allow staff nurses to access an implanted port once they have demonstrated competency (reading the current procedure and performing the procedure under supervision).  It is in the nursing procedure; does not require an MD order.

Nadine Nakazawa

Nadine Nakazawa, RN, BS, OCN, CRNI, VA-BC

Elizabeth.Raucci
We have CPOE here at Norwalk

We have CPOE here at Norwalk Hospital.  Physician must enter "Line OK to use" order which generates a "Care Set" including type of line and to use Saline and Heparin or Saline only Flushes.  Once this order is placed, the RN then orders the specific flush to match the specific catheter.  If lines are used without the "line OK to use" order or without the RN entering the flushes, an occureance report is generated for tracking purposes inorder to reeducate those involved.

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lynncrni
Your system sounds as if the
Your system sounds as if the major reason is for internal tracking and ordering supplies instead of any legal requirement for a physician order before the catheter is actually accessed and used. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Elizabeth.Raucci
Actually, because both

Actually, because both Heparin and Saline are considered medications, a physician order is required.  The Line OK to use care set authorizes this medication order.  In addition, it is the physician's responsibility to determine which patients require heparin free care, based on thier diagnosis and risk factors. 

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