[fillyupp]

hello all...I am trying to determine what the standard of practice is around the counrty regarding EVD's and JP drains or any other type of brain drain. Who takes them out? Is it RN's, PA's, APN etc........also who instills meds into the ventriculostomy if needed. I really appreciate your response...in addition what does you nurse practice act say about it...
Again thanks

[RoxanRN2003]

Always go by your facility's policy!!! As for drains, here, RNs can pull JPs (as they are in the subdural space); MDs/PAs/NPs pull the others and instill meds in the ventrics.

As for the KS NPA, I can't seem to find anything about it (though I very well may have overlooked it).

[NeuroICURN]

In our facility, the RNs instill any intrathecal meds that need to be given. However, when I was traveling, the facility that I was at, the NP did it.

As for pulling drains (especially EVDs), the MDs always do that. Probably more because we're a teaching facility and there's always a resident around.

Of course, with each facility, policy varies.

At my hospital, NPs and PAs can't even practice in the ICU. Only MDs can write orders. Well.....actually, an NP can write an order, but it must be written as a verbal or telephone order from an MD.

[ELKMNin06]

MDs do ALL intrathecals at my hosp. I work in a huge neuro institute, teaching hosp. so we always have a resident around. We take ICPs, level the drain, flush distally and draw CSF. Thats it. We can't pull any drains. We don't have any NPs that I know of, or PAs. I'm glad we don't do more than that though. I work in the ICU.

[auzzieneuronurse]

In my experience the only drains that nurses can remove are sugaleal/scalp drains/JP drains.

EVD's and subdural drains are always taken out by the medical staff as they require a suture to close. The residents are also the one's to instil intrathecal medications.