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?
I could see teaching students to calculate drip rates for basic fluids. And I think asking them to learn how to calculate how many mls per hour on med drops such as dopamine/dobutrex would be needed. I think it would be unreasonable to ask questions such as how many drops/min for dopamine 5mic/kg/min for a 72K patient.
Unless you are providing care in outer Chad you should not be hanging a med drip without a pump; it would be akin to malpractice.
I know you are dealing with nursing students who need basic skills but in my environment (NICU) we cannot give any continuous IVs without a pump.
As far as I'm concerned,it's always a good practice to learn and know how to calculate drip rates and not just relying on pumps.In the hospital where I worked,it's a part of the hiring process and our annual competency skills to pass the medication calculation for IV drips and drug calculations.It also builds up self confidence...:)
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.
I want to add for clarification....I do calculate things like mcg/kg/min frequently....but I've never calculated something like 30 drops = 1 ml to run a drip, not outside of nursing school. I didn't know anybody did that anymore in any setting. Interesting.
I work in LTC for basic fluids we use the dial flow tubing. We are expected to double check drip rates to make sure they are running at the rate they are supposed to. Height of the bag effects the flow rate despite flow settings.
I calculate drips as slow, medium, fast and wide open. Anything that isn't safe at those rates goes on a pump. I do think we should be able to calculate drip rates, but unless there's a crisis the position of the IV and patient movement would make gravity dopamine, for example, too dangerous.
Call your manger or supervisor. Hand counting drops is in itself a Med error by default. Leave that roller clamp alone- and boom- your med rate is already askew.
Do you count your other meds like that???
or do you accurately deliver meds?
IVF going into someone's circulatory system should be 100% acccurate.
Calculating gtts went by the wayside at our school until hurricane Katrina. There were quite a few faculty members who volunteered after Katrina hit. They said the number of people who couldn't figure out how to calculate and set a gtt was an eye-opener (no pumps given the number of people being treated). After that, we actually had to physically set up a line and roller-clamp those suckers to the right rate.
When I started working we had a couple of times that we had no available pumps (literally every bed and pump taken). Those who had to be on pumps were (heparin and such) but for just saline we set them up by setting the drip rate.
I forget the formula, but if shown it I could calculate the drip rate.
When once in a blue moon we need to control the IV infusion in PACU (we don't have any pumps in ambulatory surgery), we just put tape on the IV bag and mark 25, 50, 75 etc., on the tape. Then it is easy to eyeball it from time to time. This is for plain IV fluids, or an antibiotic that needs to go in slowly.
I have no idea what a nurse would do in the situation where no pumps were available if dopamine or other critical drips were ordered? Even calculating the drip rate you wouldn't have very exact control over the infusion with just a roller clamp.
blondy2061h, MSN, RN
1 Article; 4,094 Posts
Again, no one is saying we shouldn't teach dose calculation, which is not the same as drip rates.