HD catheters

Nurses General Nursing

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does anyone know if LPNs are able to use HD catheters in NH?

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Specializes in Trauma Surgical ICU.

In my state they can not. The HD cath is really not to be messed with unless there is no other choice.. We can use the blue port with an MD order for abx if we can not get a PIV started or if they do not have a PICC.. Renal pts tend to have really bad veins..

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Specializes in COS-C, Risk Management.

NO NO NO NO NO NO NO! DO NOT EVER TOUCH THAT HD CATHETER UNLESS YOU ARE HOOKING THEM UP TO THE MACHINE!!!!!!!!!!!!!!!!!!!!!!!!

(sorry, I get a bit touchy on this subject)

Seriously, if you have to ask, you shouldn't mess with it. It is not a regular IV line, not even like a central line. Please, unless you are a trained dialysis nurse, you have no business messing with a dialysis catheter at all. Ever. Seriously.

(Okay, I'm done.)

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actually, i'm a RN. we had a LPN in our dept say she saline locked one of the catheters :eek:...but i can't find any NH documentation that absolutely says LPNs MAY NOT USED HD CATHETERS....you can imagine my total shock when i heard about this. i totally agree they shouldn't mess with them.

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Specializes in critical care, home health.

The only reason a nurse should ever touch an HD catheter is if she is 1) a dialysis nurse, or 2) in the process of giving CVVHD in the ICU. Or, possibly, 3) if the patient is actively coding, there is no other way to get access before he dies, and he will drop dead before an appropriate line is placed, and the doctor tells me to do it. Also 4) if the dressing becomes soiled or displaced, I think it's appropriate for the RN to do a sterile dressing change.

If your facility does not have a policy on this, they need to write one immediately.

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Specializes in Trauma Surgical ICU.
actually, i'm a RN. we had a LPN in our dept say she saline locked one of the catheters :eek:...but i can't find any NH documentation that absolutely says LPNs MAY NOT USED HD CATHETERS....you can imagine my total shock when i heard about this. i totally agree they shouldn't mess with them.

Oh wow, we do not SL a hemo cath. If the pt is not allergic to heparin, we fill the cath with the amount listed on the clamp. If they are, we us an appropriate alternative so the cath does not clot and malfunction.. I am a renal nurse so we deal with them daily if there is no other choice (with MD order)..

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The only RNs accessing a vas cath (or AV fistula) are in HD. I can't imagine any scenario where an LPN in a nursing home (or hospital) would be able to access a vas cath/AV fistula. It is beyond their SOP.

To answer the OP:

What do you think an LPN would use an HD for?!?!?!?

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i guess she thought she was helping... :yeah:

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It really does depend on your state. And to say it is beyond your scope of practice may actually be incorrect. In the area I work in (preop), we routinely access dialysis catheters for surgery if we are unable to get a peripheral IV. You need to know the policy regarding access and wasting and should be checked off prior to this. In my hospital, it doesn't matter whether you are an RN or LPN. On other units within the hospital, it is typical for the IV team to access them if needed. However, I would not think this would be the case in a nursing home. Some states use "dialysis techs" who are not nurses to access grafts as well as catheters in outpt settings. Check your state board of nursing.

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