Help with IV infusion dial a flow!!

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Hi!

New RN here as of 8/09. Started working at an acute rehab unit in the hospital but I also do home health as a RN on the side. I had previous HH experience as a LVN.  
 

So, I shadowed a nurse at a patient’s home to do IV hydration via PICC  using a dial a flow to regulate the rate.  So as I set up everything as I learned. Spike bag, prime line, and connect to the PICC line. Since it’s a bolus, I was instructed to set the dial a flow to “open” instead of setting it as a specific ml/hr. I unclamp everything and I see that drops are falling in the drip chamber. I also use a connector that I attach to the PICC and Connect the IV tubing since it’s easier for the wife to disconnect it. 
 

The wife says every time I set up the IV it takes 10 hrs, but when another nurse does it, it takes only 4hrs.   
What am I doing wrong? Is it the setting of the IV flow? Is it the connector that I attach to the PICC?

bag is high enough, everything is unclamped,  there are no kinks and instructed them to make sure line is not kinked etc…

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Specializes in NICU.

It is the setting ,not the connector to picc line if you using standard connector.Go back to manual on instructions ,carry a index card with the instructions ,...and ask the other nurse,is this bolus supposed to go in 4 or 10???.

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Specializes in Vents, Telemetry, Home Care, Home infusion.

Info: Dial-A-Flow Tubing - What Is It & What Does It Do?

Important point: what does the physician/NP/PA order say re bolus amount per hour??    Dial-a-flow/IV controller device needs to be set to prescribed rate/ length infusion time for bolus. 

Flush the PICC line to check for patency prior to attaching dial-a-flow and extension tubing.   Height of IV pole and IV bag will affect dial a flow performance too-- make sure at least a foot above head of patient.  Drip chamber should be filled 1/3 -- 1/2 full.  Straighten tubing out to make sure no kinks, Attach device to IV bag ,  open clamps, set rate to 250 to prime tubing, attach to patients IV line then set desired rate  Periodically, IV controller arrow needs to slightly above/below rate arrow to function correctly.  Rarely when desired rate way below setting, rolling controller back and forth from 250 to off,  2-3 times gets the controller setting working correctly.  You still need to count the drops to match the set rate on the dial = providers order.  If  device does not deliver desired infusion rate after troubleshooting,  remove and start over with new device.  Another issue is to make sure patients arm not at 45 degree/bent elbow but keeps arm straight to avoid pressure on vein decreasing flow.


Video:  How To Administer IV Medication Using Gravity Infusion

How To Perform Home Infusions with a Dial-a-Flow Device

Hope this helps.

 

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