IV Assessment on Admission

[RNKPCE]

Several yrs ago I attended a class where an IV expert talked about a hospital that did an IV admission screening on every inpatient. It would start in the ER or the first unit they were admitted to. The reason for this was to determine the probable length of time of IV therapy and the reason for IV therapy. Those patient where more than 3 days of IV antibiotics was likely automatically got a PICC line unless otherwise contraindicated. Anyone who was getting an IV vesicant automatically got a PICC or central line. The instructor cited a study that said if more than 3 days of IV therapy was needed it was more cost effective to put a PICC in. It also increase patient satisfaction and comfort. Does anyone know of a tool that is in use for doing this assessment? Could you post it? I would like to bring it up at my hospital. With the increase in infections there is increase in the need for IV therapy. I think IV needs screening on admission is important.

[PICC ACE]

There are a number of places that use early assessment with good results. It bases referrals to the IV/PICC team based on known poor access as well as other factors---diagnosis (DM,osteomyelitis,respiratory failure,etc),length of anticipated stay (more than 4 days),type of medications (vesicants,irritants,high or low pH),etc. It usually ends up to be both cost-effective and better for patient to get the right device early in the hospital stay and it has also been shown that early PICC placement in PICC-appropriate patients decreases length of stay. PM me if you want more details.

[RNKPCE]

My original post was quite a few years ago. I am still wondering if someone uses a screening tool on admission to assess for IV need while hospitalized.

[NurseBean]

My original post was quite a few years ago. I am still wondering if someone uses a screening tool on admission to assess for IV need while hospitalized.

I would be curious too. We have tons of pts (mostly DM, h/o MRSA) coming in all the time with bad veins to begin with.. having a peripheral line started in ER ( with NUMEROUS attempts) then having Vanco ordered q8-12hrs...

The floor nurses get so annoyed with the docs-

Hmmm, see if you can guess how often we have to poke them for new peripheral lines after each vanco dose..? try every day! it always seems like if we could just get a PICC right off the bat, we'd all be so much better off! plus you spare the poor pt of lab draws every morning too. Do the docs even understand any of this?

[iluvivt, BSN, RN]

Bard developed a program in the mid to late 90's called Access Advantage. I think it is still available but I am not certain. I essentially gave up on it because we needed more staff to implement and the powers that be did not like that