Incident Reports

Nothing get's piggybacked with blood....you prime the line with NS, then run the blood, when blood is done, go ahead and run NS through the rest....regarding incident reports, just the facts and then finish the rest. we have been doing chart checks at shift change, and oftenI'm the only one willing to do em. I found a order on a chart, written at 0730, at 1900....to stop a drug, start another, so I had to fill one out.

Don't like doing it, but pt safety comes first.

Our blood tubing does have extra ports like regular tubing. not like OR blood tubing like you might be thinking. i do know what you mean though. because that would make sense. he had the MIVF thru another channel running at tko, pb'ed thru the blood that was running thru another channel. So both were running just fine and dandy.

Ah, I see. I call it "Y-siting" when two different infusions are on two different pumps, and one is connected to a port distal to the pump, and thus both can run simultaneously. I was taught that piggybacking is when a second infusion is connected to a port prior to the pump and is run in using the same pump, with the "piggyback" setting. When an infusion is piggybacked, the primary infusion stops while the secondary infusion runs.

At any rate, you are correct that the way the other nurse set up the blood infusion was incorrect. Hopefully the IR will be used as a training tool and not a punitive device.

I definitely think you need to pick your battles with the whole incident report issue. I come across things almost every day I could 'write up' if I wanted to. . . missed/forgotten medications, unbathed patients, writing the blood glucose from 2am as the 6am fingerstick....

But I pick my battles, I save writeups for errors that truly harm/could have harmed the patient. Example: the DKA 20-year old in a coma who came up from the ER on an incorrectly programmed insulin gtt. It said 12 units an hour, she was actually getting less than one. That, I wrote up.

I would never have written up something as minimal as piggybacking D5 at KVO into blood tubing. Against policy? Sure. Could it have harmed the patient? No. That's where you go to the nurse and say, "Hey, you probably didn't realize, but...."

Call me ballsy but after a few years you learn when to use professional judgement with your coworkers.

Kids,

I do not mean that i want to know that he 'got in trouble' for what he did. i just dont think that he will even be made aware that something was done wrong. that was my point. i dont care about anything beyond that, just that he would be made aware.

i do understand what you mean though and totally know its none my bus! lol

-H-RN