IV fluids in LTC setting?

[CrystalClear75]

Is there many IV's to run in LTC? What is the usual? Normal saline, antibiotics? This is a whole new arena for me, I imagine that there wouldn't be many IV's to run on patients... more PO meds.

Thanks for any info.

[CoffeeRTC, BSN, RN]

CrystalClear....we are from the same area (I think) and from my experiences, it just all depends. Mostly we get a good bit of IV antibiotics, mostly treating wound infections or sepsis. A lot of them are on longer term ivs so they have a picc or at least a midline in place. We get the occasional resident with IV fluids too, but most are short term and DC'd within the week.

[StNeotser, ASN, RN]

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.

We had this too. Poor people, they end up having to go to a Rehab facility where there is far more potential for infection than if they were at home. Apparently medicare would not pay for this one patient we had to have the IV at home.

[CapeCodMermaid, RN]

Don't chart that the patient was only in the facility to get the IVs...you'd spark a Medicare audit for sure. We do all sorts of IV's...PICC lines, Mid-Lines, Peripherals. I've worked in LTC where we did central lines, TPN, PCA pump. It makes sense for us to keep our residents instead of sending them to the hospital where 1)no one knows them, 2) it's far more costly,and 3) 99% of the time they come back sicker than when we sent them.

[Goofie82RN]

Yes, in California, IV fluid hydration and ATB are very common at my convalescent. Currently, I have 2 on hydration and 3 on ATB. Sometimes I think working at acute is less hectic than LTC. What do you think?

[SuesquatchRN, BSN, RN]

We see some but will be seeing more and more. CMS is pushing LTCs to keep their residents there for most therapies, including IV fluids and abx.

[alphabetsoup]

I haven't worked LTC in years. What I can tell you is that these days, PICCs are standard as are the "superbugs" that necessitate all of the IV ATBs- sometimes 6 week course of tx! So, if I was still in LTC, I would brace myself for the possibility that this would become much more commonplace.

[DDdove, LPN]

I just ran into my first clamped PICC in SN where as in the hospital they were without clamps and didn't need heparin. We only flush with 5 ml saline and 3 heparin. It just seems like so little of a flush.

[caryrey02]

At my facility we do it everyday, specially Abx.... we have plenty of infections so for sure everyday I go to work I know i will be hanging some type of abx ... IVF not that much... NSS and 1/2 NS are the most common

[gentlegiver, ASN, LPN, RN]

Any given week we have at least one patient on my unit with IVF or IV Antibiotics. Very common here in MA.

[horrorxgirl]

In LTC places I have worked, IV fluids and ATBs have been pretty common.

[NurseKatie08, MSN]

I've given plenty of IV Fluids, as well as IV antibiotics. Even once had a patient on IV Keppra.

[Nascar nurse, ASN, RN]

We give frequent IV fluids and IV ABTs all the time. Very common to admit a resident with scheduled 6 wk course of IV ABT via PICC.

It's what I keep saying over and over....LTC is NOT what some think it is. We are doing real nursing here all day every day.