Do you calculate drip rates anymore?

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So our school of nursing (in California) is revamping the curriculum. Many faculty want to do away with questions that require students to calculate drip rates or pay attention to drop factors. The main argument being that most things are and should be put on a pump. My concern is that there are times when pumps are unavailable or not working. So you need to be able to calculate drip rates.

Comments??

Does anyone know if there are regulations that require nurses to know how to calculate drip rates?

Specializes in ICU.

Yes, you should know how to calculate drip rates. I always double-check mine on my calculator just to be sure the pump is correct. Only the most basic meds we use in the ICU are programmed into our pumps, so there are some we have to calculate ourselves.

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Over the last 5 years, I've worked in a tiny (10-bed) rural hospital, a small (50-bed) community hospital, and a large (700-bed) regional medical center.

In each case I've had to calculate drip rates and durations due to a lack of pumps. I don't generally put things on pumps that don't need to be on pumps...

Also, flow-metering devices (e.g. "Dial-a-Flow") only limit the MAXIMUM flow rate, they don't assure any minimum flow rate, so if you want to know how fast it's ACTUALLY running then you need to count drops and do the math.

I guess my simple response would be, "Why do away with something that is so foundational and so very, very simple to do?"

Frankly, IMO, anybody without the minimal sense required to calculate simple drip rates has no business being a clinical nurse.

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Specializes in Emergency.

If any of your students wind up in the ER, they will absolutely be calculating drip rates.

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Specializes in Anesthesia, ICU, PCU.

Just got done running IVF by gtt rate all night. Nothing serious, just NSS, but you gotta do what you gotta do when there aren't any more pumps than what you got for the stuff that absolutely needs them!

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Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.
In addition, there are certain things that you can't run on a pump. At my hospital, we have to hang platelets to gravity because they will clot/clog up the pump. It's not something I've gotten to do yet, but I know for sure we don't use a pump for them. There are other meds and care settings where pumps aren't used.

I've been a nurse for, let's say, quite some time and I've never heard of this. I used to run platelets on pumps all the time. There really isn't any way they could "clog" the pump as they are enclosed in tubing. Also, I'm curious to know what things can't be run on a pump? I've never run into anything of the sort so it will be a great learning opportunity fo rme.

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Specializes in Inpatient Oncology/Public Health.

We don't run platelets on a pump but I was under the impression it was because the pump would harm the delicate platelets. That said, we don't really calculate a drip rate to do it, just start it slowly then speed it up a bit to go in over about an hour.

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Specializes in Acute Care, Rehab, Palliative.

We run platelets on a pump.

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Specializes in ER, Forensic Nurse, SANE.

In home health, we dont use pumps. Everyone needs to know the basics.

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Specializes in Pediatric Critical Care.

I've always run platelets on a pump too. I thought the only places that ever might calculate drop factors anymore would be someone doing missions work in a 3rd world country or something like that. ERs run blood and fluids wide open sometimes, but that doesn't require calculating a gtt factor.

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yes you must know your drip rates to double check RX label and doctors order which may be wrong. You also need to know nl dose

ranges for which indication eg hi dose/ low dose Dopamine. having been a CC nurse for 15 years I cant tell you how many times

I have assisted a fatigued doctor or one with bad hand writing the correct dose. most hopitals have flow charts for this created by RX.

And many drugs are mcg or mg by KG, thats 3 opps for error if any one are wrong or omitted (very common)

Also be aware that with IV pumps you cannot count the drops in the drip chamber beause it is a "volume set"which pulls

fluids 5-10 mls, depending on the cassette,company used. These pumps depending on the manufacturer are 98-99.999% accurate

versus "volume controller" pumps typically used for tube feedings or less critical administration which have an electric eye which counts drops and which you can see and also count. Their accuracy is usually about 90% and they are a heck of alot cheaper

Old Baxter (travenol) sales chic

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Specializes in Oncology.

It's against policy to run even fluids to gravity in my hospital. We have ample pumps and don't even have gravity sets. If a drug isn't in our Alaris library we just run it as a basic infusion, so I'm not sure what that is relevant, regarding the second reply. As to the first reply, the OP didn't say anything about dose calculation. I haven't calculated a drip rate since nursing school and can't remember how to do it. The only thing we do to gravity is platelets, and we don't have a specific rate for those.

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Specializes in Oncology.
Yes, you should know how to calculate drip rates. I always double-check mine on my calculator just to be sure the pump is correct. Only the most basic meds we use in the ICU are programmed into our pumps, so there are some we have to calculate ourselves.

I think you're thinking of programming a pump for a dose and double checking the rate. This is different than counting drips to make sure you're going at 85ml/hr or whatever.

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