I have reviewed the Texas administrative code and have found several articles supporting this practice. I would like to hear your interpretation of the code not just opinions please.
http://info.sos.state.tx.us/pls/pub/readtac$ext.ViewTAC?tac_view=4&ti=22&pt=11&ch=224&rl=Y
http://emedicine.medscape.com/article/1433943-overview?src=emailthis reading from the references
Scenario
An unlicensed tech that is proficient in PIV starts. Has annual competency. Has taken a didactic and practicum on USG-PIV placement with a mentorship of 1 year. Has a hospital policy in place. Does not do the procedure without an RN within close proximity. Accesses only the peripheral (cephalic, basilic of upper and lower arms.) veins not deep (brachial) veins of the arm. Allows the RN to access no stick zones (i.e. mastectomy, burn, fistula, etc.)
IYHO does this reflect the statue?
The only issue is the fact that there can be patient specific decisions required when a peripheral catheter is inserted. Skin antiseptic agents based on allergies, catheter gauge size based on infusion therapy required and diameter of the vein are just 2 examples where nursing assessment and judgment would be needed. When this is the case, the procedure should not be delegated. Also the RN that is doing the delegation must have the same skills so the RN could take over the procedure if necessary. Those are the only things that could cause some issues for you. Lynn
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
I'm getting push back from senior Leadership to train bedside nurses to use u/s to place IV's. They are missing the piece that the RN has to be proficient in IV placement and that it is a learned skill. It's not taught in one day. Apparently I make it look too easy. What are other hospitals doing? I'm advocating a very few number of RN's learn this skill.
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