IV fluids in LTC setting?

caliotter3 · Aug 10, 2009

Occasionally we would get an order for IV antibiotics and that was pretty much it. IVs were pretty much the exception and not the rule. Saw more of them in the subacute unit than in the long term units.

nyteshade, BSN · Aug 10, 2009

State of FL...IV hydration: NS, D5 1/2NS, LR...IV ABX, yep a lot...guess it depends on where you're at...also seeing more midlines, PICC lines, and yes CVPs...

NC29mom, ASN, LPN, RN · Aug 10, 2009

the ltc facility that i work in does administer ivf and at times iv abt. however, where i work is attatched to a small er (2 trauma rooms and maybe 10 beds), so any residents that receive iv abt usually are transferred down the hall & admitted to er (payment issue-medicare will pay if in er but doesn't pay much if in ltc).

yes, ivf and iv abt are administered in the ltc setting.

CrystalClear75, BSN, RN · Aug 10, 2009

I live in Pa...thank you all so much for the responses(and future ones). :up:

PAERRN20 · Aug 10, 2009

Work in an ER here. LTC's usually send patients to the ER to get IVF/ABX. However, if the pt had an IV in the ER but is getting sent back, the IV comes out. We don't send pt's back with IV's left in place. Usually they get the 1st dose IV and then switched over to PO.

Mabel 29 · Aug 10, 2009

i'm a lpn working in ltc in pa. just went for iv therapy certification last week. the facility is taking more iv, midline and picc patients.

TheCommuter, BSN, RN · Aug 10, 2009

We give simple IV antibiotics at the nursing home where I am employed, and the patient's IV access will usually be a PICC line.

One of my current patients is receiving Zosyn IV Q8 hours and Vancomycin IV Q24 hours for a wound infection. One of our previous patients was receiving Nafcillin IV Q4 hours around the clock for infective endocarditis secondary to intravenous drug abuse.

mappers · Aug 10, 2009

My brother lives in a LTC and has a port. (He's a quad). He will bet IV ABX in the nursing home through his port, but I don't think the NH will access his port. I think that is done in the hospital or Dr.'s office.

If we send patients to a NH with IV ABX, we usually send them with a PICC, not a peripheral IV.

And on a side note, we had a patient once who needed to go home on IV ABX. Medicare would not pay $40.00 a day for a HH nurse to come administer them, so they sent him to LTC for the 10 days. How does that make sense? (They guy was capable of self care and had a spouse at home with him too that was capable.)

Mabel 29 · Aug 11, 2009

I remember a similar situation to the above post. The fellow was young and lived home with his spouse. He was admitted to the LTC facility /Rehabilitation Center for ABX IV therapy. He used to sign himself out and have his wife pick him up. He would go home and return five minutes prior to his scheduled therapy. Once the therapy was finished, he would leave again. A home health nurse would have been so much more cost effective.

mappers · Aug 11, 2009

LOL...Smart guy. I wouldn't have thought of that.

southernbeegirl, BSN, RN · Aug 11, 2009

we give tons of IVs!

we have lots of patients admitted for IV antibiotic therapy longterm. if a patient's input is low we sink an IV for fluids quickly. bp low? IV in. i actually run more IVs in my current setting than i did in the hospital.

many patients have PICCs for the long term therapy but i am forever running around starting IVs. we also have patients with ports that we access and use on a routine basis or we access monthly for flush.

we are basically a short stay rehab center with about 25 long term residents.

to the ER nurse...ive always wondered why in the world you guys remove the IV that you just started in the ER if you know the patient is coming back on IVs??? it's not like an ambulatory patient that is going home. that i can understand. but we are talking transfer from one health care facility to another, usually via ambulance. why do you guys do that and cause the pt to be stuck AGAIN? that has never, ever made any sense to me!