Do you stop infusion "for a walk?"

[rkitty198, BSN, RN]

"I want to go for a walk and a shower," "will you unhook me?"

Do you stop the IV infusion to allow the patient some freedom?

Times where it really bothers me:

-Patients who are on PCA's who want to go out to smoke (which we have sign a consent for leaving the building).

-Patients who need an IV abx and will have treatment delayed until they are ready.

-Those who have peripheral IV's which end up infiltrating, leaking or falling out which adds more time to my day because I have to put in another IV, which then delays more treatment.

-I am stopping an infusion which is a doctors order

-I have to get back into the room asap to restart the infusion (PCA's, ABX) because going for a smoke puts the patient in a pain crisis and then suddenly they need their PCA again.

(by the way, we do give nicotine patches for those who smoke, and we have them sign a consent when they leave the floor)

What is your practice?

I am starting to think about saying "no."

[loriangel14, RN]

I wouldn't do it if they had a med running but I have done it with a patients that just have NS running so they can have shower. If they want to go for a walk on the floor they can take the IV pole with them.

[WickedRedRN, BSN, RN]

Can't leave the floor with an IV because I am legally responsible for their condition. If they are infusing meds, I need to be able to monitor for any potential problems/issues with med and iv. Constantly hooking and unhooking the iv puts them at greater risk for infection and infiltration, so no, I won't do it. A shower can wait til infusion is completed, and you can walk on the floor with the pole.

[linearthinker, DNP, RN]

I'd want an order to do so, but with that protection, sure. I gave up trying to force people to comply with medical advice and safety issues. After I CMA they can follow the lemmings off a cliff for all I care.

[Forever Sunshine, ASN, RN]

I don't have residents that get infusions(maybe a new admit here and there) but my question is would it be possible to have the patients wait until the treatment is done? This might not always be possible with PCAs but at least with the IV abx.

[Flo., BSN, RN]

I would disconnect a PCA but not a med infusion.

[joanna73, BSN, RN]

Same. PCA or NS or TKVO I might disconnect for a few min, but not if they had a med infusing.

[steelydanfan]

Can't leave the floor with an IV because I am legally responsible for their condition. If they are infusing meds, I need to be able to monitor for any potential problems/issues with med and iv. Constantly hooking and unhooking the iv puts them at greater risk for infection and infiltration, so no, I won't do it. A shower can wait til infusion is completed, and you can walk on the floor with the pole.

I do agree. Pt.s and some transport techs think that we should "just" unhook the IV whenever it is convienient for them.

An infusion of whatever is ordered to be "continuous", and NOT interrupted for convienience. Everytime an IV is interrupted sends the infection risk up by 35%, according to some studies.

[evolvingrn, BSN, RN]

we actually have portable infusion pumps. We do lots of pca's and they don't have to hang so we put them in a small arm bag and they can go whereever the want with it. I have seen people smoking on the street with their pca 'purse' around their shoulder with just fluids i would have no problem stopping it but a med/abx infusion i would not stop because they are getting those at scheduled times for a reason.

[R*Star*RN, BSN, RN]

My patients go for a walk with their infusions. Most of them have important meds like heparin, dobutamine, or insulin. If it's an antibiotic the walk/shower can be timed around it. But if they are on a med gtt other than NS I'll push the pole down the hallway and walk next to them and have a nice conversation :)

Since most of my patients have some sort of central line it's hospital policy not to let them leave the floor, so if they smoke we supply them with nicotine patches.

[carolmaccas66, BSN, RN]

We are not allowed to stop infusions for any patient (unless the line is blocked and machine is beeping like mad). A Dr can only desist an IV infusion.

What is so hard about saying no? And if you cease infusions, how on earth do your patients get any drugs at all?

This seems really strange to me.

[BluegrassRN]

I will only stop certain IV fluids for a shower (NS at 50 or less an hour, for example). I'm not interrupting an abx, heparin, or anything else important for a walk or a shower.

If the pt wants to walk, they can push the pole. If a patient wants to go outside, that's their business and their responsibility.

If they want to go outside to smoke, per hospital policy they are leaving AMA, so when they get back to the floor, we have a chat. If they leave again, I'll go down to find them, hand them their AMA paperwork and all their belongings, pull the IV, and they can come back in through the ED if they feel the need (I've only had to do that once).