All Med-Surg patients require an IV site

[Bremin5099]

I am looking for your leadership on this subject. Do your Med-Surg admission policies require that all patients have an IV site on admission regardless of diagnosis?

[Jem-RN]

It is not a REQUIREMENT to have one, however, most of the time a patient will have IV medications on a med/surg floor. Even if there is a PRN med where the route is IV, the patient must have it. I work on both a med/surg and tele. Our patients on tele DO NEED AN IV site due to the tele medications in the event of an arrhythmia.

[dfs1961]

I work on a medsurg telemetry floor and it is our policy that all patients on tele have an IV. That being said, not all of our patients are on tele, so obviously not every patient on my floor has an IV.

[dfs1961]

I work on a medsurg telemetry floor and it is our policy that all patients on tele have an IV. That being said, not all of our patients are on tele, so obviously not every patient on my floor has an IV.

[Rob72, ASN, RN]

Generally, for the reasons above. I can't really think of an Internal Med or any specialty admit that would qualify for admission, and not have the potential for acuity that would need IV access.

Of course, they can always refuse... just be sure to document.

[Aurora77]

I'm not sure what the official policy is, but our pts have IV access until they're discharged unless they absolutely refuse. We get post ops and need options just in case they go south. Plus, most have at least PRNs ordered IV.

[Jolie, BSN]

This may be an insurance reimbursement issue. If a patient does not require skilled nursing care (IV therpay being one example of skilled nursing care), his/her insurance company may refuse reimbursement for inpatient care.

If your patients are not in need of IV therapy, there had better be a documented example of other skilled nursing care, or your hospital may be denied reimbursement.

[turnforthenurse, MSN, NP]

I work in progressive care and it is policy that patients have established IV access. What if the patient codes? You need access.

[JustEnuff2BDangerous, BSN, RN]

We require all patients on telemetry to have IV access, saline locked or otherwise. Most of our other patients do have IV access, but if the patient is stable, has no IV medications on their medication profile that they are receiving, does not have co-morbidities (if they are diabetic, I automatically keep an IV site, in the event I have to administer Dextrose IV), and not on tele, I will usually pull the IV site if it's over 96 hours old. Emergencies happen and there's no guarantee this stable, non-teled patient won't code or become unstable, but you also don't want to keep an invasive line in if there's no immediate need or use for it, as it is just another avenue for nosocomial infection.

[birdie22]

The docs automatically put an order for an IV. If for some reason we have trouble getting access, and/or they dont need any IV meds and of course are relatively stable, we can ask the doc if its ok if they dont have an IV. And in that case, I always write a small note, 'no IV access, MD aware'

[R*Star*RN, BSN, RN]

It's not required but in my opinion everyone should have an IV site. Why? So if they code you don't have to fumble around to get access. Even if the diagnosis is stable, anything can happen.

The only time I'm fine with the patient not having an IV site is if they are on hospice or palliative care and that is their wish. But it's still nice for that morphine gtt.