[Sue McGann]

The hospital wants to change their policy stating that nurses may initiate central line IV therapy prior to catheter position confirmation with a chest x-ray. What are you doing in your hospitals???

[kc ccurn]

At our hospital we must have CXR done for line placement. The only time we don't is if the line was just changed over a guide wire and there was no needle stick. The only other time I've used a central line prior to the CXR was in a cor situation with MD order.

[mags-rn]

Our policy is to obtain a CXR, but not infrequently we start using them before the CXR, especially emergent/urgent situations.

Think about the OR. Central lines and ET tubes are placed and used for hours without confirmatory CXR.