Hello, Reaching out regarding a PIV policy to help support unneccessary PIV sticks when patinets do not require IV medications. Many times the vascaular access team is called to insert an ultrasound guided PIV when Nurses tried several time "they are a hard stick" When reviewing the pts chart there is no IV medications and no indication they need vascualar access. Most of the time we review with MD and many agree and will order "NO PIV needed" What I am interested in is to have the language in our policy to help support the practic eof not inserting "Just in case or idle PIV's", Does any one have this in their policy already??? There are still some MD's that wan the PIV "Just in case"
Is there a policy calling for a PIVC in all patients? Or is this coming from a provider's order for a PIVC insertion? If neither then why do the staff nurses think they should be placing one? No clinical indication means no idle catheters. I have never seen the need to have this in a policy.
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, This is coming from MD's who are ordering the PIV's (due to nurses asking for them) stemming from when nurses are restarting PIV's and are not successful then they call the Vascular access team. We then review this pt to see what the need is and find the patient is not on any IV medications. When asking the nurse and MD the response is "we need on just in case or all pts on telemetry must have an IV" Some are reseptive and will say can leave IV out until needed but for those that are not I would like to change this culture of thinking of the staff that all pts need PIV's. Patients are complaining they have been "stuck and stuck over an over again" and it makes me very upset to hear this. My vascular access team inserts PICC/midlines and the USGPIV are for the difficult access pts and they have been abusing the team for numerous unneccessary PIV's. I am trying to find the right language to either place in with the PIV policy is need to be or like you mentioned "Clinically indicated" this term which is in our policy I can re educate them stating if there is no IV medications then a PIV is not clinically indicated. Reaching out for support to change the culture. We as a team have avoided inseting many unneeded PIV's. What I feel is that I need a supportive statement to back us up, or is it appropriate to mention the INS standards?
Michele A. Lawson MSN,RN- BC, CRNI
Locate the data by searching for studies on "idle catheters". You will find that complication rates are high, that when needed they don't function. This is an education thing, IMO.
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!!
Michele A. Lawson MSN,RN- BC, CRNI