Nurses Managing Epidural Pumps? | allnurses

Nurses Managing Epidural Pumps?

  1. 0 AWHONN clearly states that manipulating epidural pumps in any way is not the role of the OB RN. So, please just tell me briefly what state you work in and if nurses are permitted to adjust pumps, especially increasing the rate, where you are.

    Thanks!!
  2. Visit  mommy2boysaz profile page

    About mommy2boysaz

    mommy2boysaz has '10' year(s) of experience and specializes in 'OB'. From 'OH'; Joined Mar '07; Posts: 287; Likes: 111.

    12 Comments so far...

  3. Visit  klone profile page
    0
    AZ and CO, and we can shut them off, that's IT.
  4. Visit  Fyreflie profile page
    0
    Up here in Canada I've worked in three facilities with completely different rules. In the first, we had a medical directive not only to manipulate the rate within a set range, but also to give top ups as ordered and to troubleshoot.
    In the second, we could change empty bags and prime the initial bag while waiting for the anesthetist but that was it.
    In my current facility, we can turn up the rate by 2 or the bolus dose by one and occasionally we have to program the pump to start (as well as changing bags). Anesthetists get called for everything else, including troubleshooting.
  5. Visit  IrishIzCPNP profile page
    0
    I'm in PA. We prime the pump, hook up to catheter, set up rates in pump, give bolus via pump, change rate if ordered, start and stop pump.
  6. Visit  RNinLDRP620 profile page
    0
    OH, we decrease the pump at the discretion of a physician at the bedside if pt is too numb to push and shut the pump off. That is it.
  7. Visit  melmarie23 profile page
    0
    we can turn them off here in NH. If a pt has a persistent window or she is too numb to push, we call anesthesia.
  8. Visit  Alikatz profile page
    0
    I'm in CT and where I work we turn it off. Anesthesia takes care of anything else.
  9. Visit  dah doh profile page
    1
    I'm in CA, not sure about the OB area, but in ICU, the epidural order set has a range that the nurse uses to titrate to effect. If we have issues or problems, we call the pain management or anesthesiologist. They prefer we crank up the epidurals for pain relief prior to sending the patients to med-surg floors because those nurses are nervous about messing with the rate unless they call the doctor even though the order set is the same. We can initiate and discontinue the epidural drip. The doctor manages the catheter and dressing changes.
    NurseKatie08 likes this.
  10. Visit  SaoirseRN profile page
    0
    I'm in Canada. We are allowed to adjust the settings on the pumps, including increasing the rate, but only with an order. We have a protocol to follow for monitoring with any rate change.

    Often epidural orders often come with a range which we can titrate (up or down) the rate and/or the delay according to the patient's needs. If we reach the maximum upward adjustment then we would have to call the anesthesiologist, but having room to adjust is nice and ends up with fewer delays in achieving good pain control for most patients. Because the orders are first set by the anesthesiologist, we aren't doing this independently, even if we are making adjustments to the pumps directly.
  11. Visit  eden profile page
    0
    I am also in Canada. At my facility we can prime, program, start and adjust the rates. It is a 2 nurse check to adjust and start the pumps. We can also do top ups but if we have given 2 and they are still uncomfortable then we call back anesthesia. Before we can do top up we have to be signed off by an anesthesiologist.
  12. Visit  itsnowornever profile page
    0
    Quote from IrishIzRN
    I'm in PA. We prime the pump, hook up to catheter, set up rates in pump, give bolus via pump, change rate if ordered, start and stop pump.
    CA here. Same as above

    Posting from my phone, ease forgive my fat thumbs!
  13. Visit  knitter523 profile page
    0
    Quote from mommy2boysaz
    AWHONN clearly states that manipulating epidural pumps in any way is not the role of the OB RN. So, please just tell me briefly what state you work in and if nurses are permitted to adjust pumps, especially increasing the rate, where you are.

    Thanks!!
    AWHONN is only a professional organization. They are not a licensing body and therefore cannot dictate what is within the scope of practice.

    Your state Nurse Practice Act can provide information regarding management of patients receiving epidural analgesia.

    My state (WA) has an excellent document describing what the scope of practice is regarding epidural management.

    http://www.doh.wa.gov/Portals/1/Docu...0/Epidural.pdf
  14. Visit  smdechant profile page
    0
    Virginia:We can adjust the rate, if a range is ordered, change out an empty bottle, and turn off the pump after delivery.


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