Do you clear your PCA pumps at the end of the shift and when you change the bag out, or just when you change the bag?
Jan 24, '01
at our hospital the policey is to clear vol q8. and to write down #attempts and # injection q shift. that is the policey but i dont know that it gets done that way all the time hope this helps.
Jan 24, '01
At the hospital I work for, we clear pumps at shift change and when we put in a new syringe. Also, when when clear the pump it must be witnessed by two nurses. It is followed by all the nurses.
Jan 24, '01
The policy at my work, and we use a lot of PCAs, is to clear out q4... we have a PCA flowsheet that records the RR, pain scale, injections vs. attempts, syringe balance, amount administred in four hours, total drug administred since start, alternative therapy, and whether we just cleared the pump or changed the syringe.. it should be done by two nurses, but often there is only one nurse working, so it falls totally on his or her head.. i find this way ensures there is no chance for the patient to be over medicated or undermedicated...
Feb 3, '01
Hmmm... we must be odd. I do ortho with every pt on a PCA from surgery. Our pumps are not cleared. The number is the total dosed to the pt since started. Our flowsheets are q4h with total dose, and q8h delivered, q4h v/s and quality of pain relief. We only need 2 nurses to sign for any wastage when PCA is d/c'd and our pumps use 30cc syringes straight from the manufacturer. They're old but simple to use and straightforward.
Incidentally, ever hear of a PCA without an IV infusing?
Feb 8, '01
At my hospital we do the same - the PCA is for the duration of therapy and the flow sheet is q2h. The number attempts, successful delivery, and volume is noted. I have seen PCA's attached directly to saline locks with no fluid infusing....and no continous delivery - demand only. Is that what you were asking?
Feb 16, '01
PCA and no mainline IV at least at KVO? Is that not like waving the drug over the patient? The amount of fluid infused needs to exceed at the very least the length of the cannula for the drug to be delivered into circulation!? I hope your pumps have a q4 hour lock out and not a q1 hour lock out!
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