Hi All,
There has been an excessive number of PIVs in patient's thumbs and fingers from an ED. The feedback the VAT gets is "that's all we can get, what else are we going to do?" Our suggestion was to involve the ED MD and that idea was met with cokmplete restance. Does anyone have any source documentation we can give this Director? I have already sent S 81. Site ASelection of SOP 2021.
I would agree that referral of these DIVA patients to the ED MD is the wrong thing to do. There is no guarantee that their skills will be higher than the nurses. You need some way to increase vein visibiity. Start with evaluating near infrared light devices that will find superfical veins that the naked eye cannot see. YOu could step up to having them do ultrasound guided insertions but that is a skill that takes a long time to learn and many patients. Near infrared light is better for starting. As backup the VAT needs to be reachable to go to ED when there is a patient they cannot stick, even with the light device. We cannot complain about their site choices if they truly cannot do better. We have to provide ways for ED RNs to have better success.
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Thank you Lynn. I should have been more clear. I was referring to the ED MD for possible EJ placment as our organization does not have an EJ competency in place. Some ED RNs do place US GUided PIVs, outcomes have not been great with dwell time and appropriate site placment.
Thanks for the information as always
Newbie
EJ is a problematic vein. it is extremely tortuous and has a high risk of extravasation when used for CT contrast or other vesicants such as electrolytes and vasopressors. I would rather invest time into developing the competency of the ED RNs to use US.
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861