Every hour IV medication

[sistrmoon, BSN, RN]

If you work on a med surg floor, is there a policy about every hour IV pain medication? Ours are supposed to be converted to a PCA pump if they are really taking it that often but it's not happening in practice, which is challenging with a full patient load.

[RNewbie]

I don't know if my hospital has a policy on it but if yours does just call the doc...explain the situation and "per policy" the pt should be on a pca.

[blondy2061h, MSN, RN]

We've had to do this if we just didn't have enough IV access to accommodate a PCA. Then it's really a pain because you're having to stop your other drips, disconnect, and give your med. Otherwise, people requiring pain meds that often are on a PCA.

[loriangel14, RN]

You can ask for a PCA and just have it a SC access. It doesn't need to be IV.

[sistrmoon, BSN, RN]

The last patient I dealt with this, 3 different doctors were called and none would switch to a PCA.

[RNewbie]

Well if the doctors are refusing to follow policy I'm sure the medical director or whoever is in charge of them can enforce it.

[blondy2061h, MSN, RN]

You can ask for a PCA and just have it a SC access. It doesn't need to be IV.

We do not have equipment for this. We don't have subq pumps.

Edited to add: I suppose you could use the usual IV PCA pumps. We do have subq sets we use for injections, but I've never seen any kind of adaptor to connect tubing to it.

[jadelpn, LPN, EMT-B]

Does your hospital use sub-q locks? Quite old school, however, effective...

[loriangel14, RN]

We do not have equipment for this. We don't have subq pumps.

Edited to add: I suppose you could use the usual IV PCA pumps. We do have subq sets we use for injections, but I've never seen any kind of adaptor to connect tubing to it.

You don't need a special pump. It's a Luer lock connection just like an IV. You set it the same , it's just going SC instead of IV.BD nexiva IV - Bing Images

[ArtClassRN, ADN, RN]

If you work on a med surg floor, is there a policy about every hour IV pain medication? Ours are supposed to be converted to a PCA pump if they are really taking it that often but it's not happening in practice, which is challenging with a full patient load.

It depends on the patient.

[KelRN215, BSN, RN]

Patients couldn't be on q1hr ANYTHING when I worked on the floor. Q2hrs or less frequently on the floor or they were in the ICU if they needed more frequent meds/monitoring/assessments, etc. They could be on a PCA on the floor.

[dudette10, MSN, RN]

In situations like this--where a higher level of care is not necessary and a switch to PCA is not gonna happen-- best to talk with the charge about proper acuity classification and making appropriate assignments.