Do the new INS 2011 guidelines address tip verification when a patient comes into your facility for infusion treatment. I can find the guideline for xray when the line is placed...but what about patients who come in with an indwelling line... Does the same standard apply?
Sarah Jones RN, MS, ACNS-BC, AOCNS, CRNI
The standards are based on evidence and they are no procedural. I am not aware of any evidence about the issue of repeating an xray when a patient is re-admitted with any type of CVC. With that being said, you need to read Standard #13 Plan of Care and #53 Central Vascular Access Device Malposition. Then create your hospital's policy based on meeting these standards. Secondary tip malposition does happen and it does lead to serious outcomes. Catheters are sometimes not properly positioned on insertion, then your facility infuses irritating fludis/meds causing vein thrombosis, etc. My advise would be to always know the location of all catheters based on insertion records, previous xrays, etc. Know the signs and symptoms of malposition and know when to obtain a repeat xray to assess tip location. 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