Does your facility require a physician order to double concentrate an IV drip?
In my facility, we mix some of our own drips, e.g. 40 mg Neo in 1000 ml NSS (or 20 mg in 500 ml).
We have no hard and fast policy on mixing drips or double concentrating them (or even quadruple concentrating them if we are really trying to limit fluid intake).
I did not think we needed an order to double concentrate a drip. Another nurse told me that we had to get an order before we did so. When I asked her why, she said "just because that's the way we've always done it." When I said, ok, putting that aside, why do I need an order to double concentrate a drip, she replied, "You are altering the dose of medication." I disagree. I feel like it's 6 of one and half a dozen of the other..I feel as though I can compare it to this, even though the situations aren't exactly the same...if a 1 L bolus is ordered and I use 2 500 ml bags versus 1 1L bag, what is the difference? If 0.5 mg Ativan is ordered and I split a 1 mg tab in half rather than use a 0.5 mg tablet, what is the difference? Thoughts?