Documenting Ultrasound Guided PIV's

[Brooksy86]

I have been helping overhaul some of the policies for documentation. I just finished the guidelines outlining standard PIV's but want to add an option in our software stencil for Ultrasound based IV but I can't find any literature about what extra's need to be added for that procedure. Can anyone help with this?

[TU RN, DNP, CRNA]

Add one small click box that says "Ultrasound-guided" or "USG," if you absolutely must. If you are a registered nurse who places ultrasound-guided peripheral IVs, then you already know how time-consuming they can be. This skill is usually practiced in combination with a standard, level-of-care appropriate patient assignment. The nurse is doing enough already just walking away from those patients to do the thing in the first place.

[Brooksy86]

I do these almost on a daily basis in our ER which is why I wanted to add this, but I wasn't sure if there should be additional info like how we verified placement since there is both flushing and drawing as well as changing to a long view on the ultrasound and visualizing the catheter in the vein. Things of that nature. The CDC and Infusion Nurses Society has guidelines about everything in relation to normal IV's but I can't find anything for this. Though it shouldn't matter what hospital it's for but since this is going to be a stencil for the entire V.A. system I really want to make sure this is done right the first time.

[iluvivt, BSN, RN]

It does need to be documented that it was an USG PIV and the vein should be identified especially if it's one of the larger veins such as the cephalic.The length of the catheter also needs to be documented.The option to write a narrative note should always be available as well.If the patient has poor veins so much so that US is needed it's a good time to communicate with the provider about the type of access the patient may need for the prescribed IV therapies,that can go in a narrative note.

[Here.I.Stand, BSN, RN]

We use Epic; we just have a yes/no click box

[AnnieOaklyRN, BSN, RN, EMT-P]

At my hospital it is just a check box AND we get add a copy of the US picture in the patient's chart.

Annie

[Rocknurse, MSN, APRN, NP]

I work for Epic. Just contact your informatics dept and speak with the Epic Inpatient team (if that's the EMR you use) and tell them what you need. They will determine the best way of documenting that, probably with a flowsheet type button that is incorporated into your lines, drains and catheters section for documenting a new PIV.