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Ward Nurses adminstering TPA for occlusion mangement



I have been wondering what hospitals are doing for "best practtice" with occlusion management where they do not have the benifit of a IV team. I am confident that nursess can learn to adminster a dwell time intilation and reassess for occlusion clearing.

The reason being is that I keep hearing that the cost associated with possibbly "over treating" where adequate flsuhing or confidence in flushing a PICC line underestimates if the just needs a little "boost" or is really showing sogns of occlusion.  Partial or complete occlusions are possible being over treated?

I tend to beleive that an ounce of prevention (avoiding delay in treament or reduce line infection) it is cheaper to instil a dose of TPA and therfore the argument is not reasonable to not assume that it is reasonable for a ward nurse to treat a possible occlusion in the setting where IV teams do not exist.




I firmly believe that a full

I firmly believe that a full service 24/7 infusion team is the best siutation and patient care. Without that, you must designate who can do these procedures and document their competency thoroughly with the intervention which includes when to use it and how to prevent the problem in the first place. Just turning this over to every staff nurse without documented compeency is never appropriate. 

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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