At my hospital, we were recently informed that any IV site found without a date would be removed at the moment of discovery. By that I mean, management making pt rounds. I believe in labeling tubing, sites and dressings. I am not perfect and may slip up on occasion. However, if I was the pt that had their IV site removed becasue there was no date, I would not be happy.
In the day of striving for 100% pt satisfaction, I cannot see how this will help. Plus the nurse who has to restart the site, probably wasn't the one to start the site.
This reminds me of about 8 yrs ago when MD'S didn't have their records up to date, all procedures they had scheduled were cancelled. Can you imagine prepping at home for a colonoscopy only to get to the hospital and find it cancelled because you DR didn't have his paperwork done.
I truly believe that all health care should be carried out in the safest and best manner possible. But some of the ideas to make it better, do they really help make it better or just create more work for the nurse and more dissatisfaction for the pt?
I make a habit to date and time an IV when I start one, but not everyone does. The little date/time sticker that comes with our tegarderm also doesn't always stay on...so I'm sure after awhile those dates/times just fall off. We have computer charting so when we chart a new IV, we also put the date/time it was started. If I don't see a sticker on the actual IV site, I'll do a chart check.
Did anyone ever consider asking the patient if they remember when the IV was started? A&O patients will likely remember. And I agree, I'd throw a fit if this happened to me or a loved one.
Specializes in Gerontology, Med surg, Home Health.
The last three times I was in the hospital as a patient, I had IV's. It was agony getting them started. None of them were dated. If anyone had tried to remove them simply for lack of a date, there would have been a commotion. Surely there is room for a bit of common sense.
Guys, keep in mind why they are so anal retentive about the dating -- joint commission. They say you increase an infection risk if you leave a line in more than 72 hours -- half our patients, you're tickled pink to have a peripheral, because docs won't put in a central because they no longer get paid as much for doing them as they used to. So you've got a 22 in an upper extremity, guarding it with your life, and they want to pull it? They better figure out where they're putting the next line. Wait until an ICU patient dies because some nimrod pulled an IV and they can't get levophed/dopamine/dobutamine/blood they need to live -- but hey, the paperwork's in order.
Half the time you end up with beds that don't work or weigh the person on 10 mcg/kg/hr drips, IV pumps that alarm over nothing , short on nurses, short on supplies, Levophed on backorder, physically dangerous patient who need inpatient psych treatment, now thrown into ICU because nobody else knows what to do with them, but oh, yes, JC is harping on labeling IV sites, so let's focus on minutae so we don't have to look at the herd elephants in the room.
Guys, keep in mind why they are so anal retentive about the dating -- joint commission. They say you increase an infection risk if you leave a line in more than 72 hours -- half our patients, you're tickled pink to have a peripheral, because docs won't put in a central because they no longer get paid as much for doing them as they used to. So you've got a 22 in an upper extremity, guarding it with your life, and they want to pull it? They better figure out where they're putting the next line. Wait until an ICU patient dies because some nimrod pulled an IV and they can't get levophed/dopamine/dobutamine/blood they need to live -- but hey, the paperwork's in order.
Half the time you end up with beds that don't work or weigh the person on 10 mcg/kg/hr drips, IV pumps that alarm over nothing , short on nurses, short on supplies, Levophed on backorder, physically dangerous patient who need inpatient psych treatment, now thrown into ICU because nobody else knows what to do with them, but oh, yes, JC is harping on labeling IV sites, so let's focus on minutae so we don't have to look at the herd elephants in the room.
*sigh*
Isn't this so true about so many things in nursing? And increasingly so with every year that passes...
I have been a patient more times then I can count. I am a VERY difficult stick (often end up in my feet due to not finding other things) I would not let them and would raise HOLY HE!! if someone tried to remove it due to it not being dated!!!!!
Specializes in LTC, assisted living, med-surg, psych.
Guys, keep in mind why they are so anal retentive about the dating -- joint commission. They say you increase an infection risk if you leave a line in more than 72 hours -- half our patients, you're tickled pink to have a peripheral, because docs won't put in a central because they no longer get paid as much for doing them as they used to. So you've got a 22 in an upper extremity, guarding it with your life, and they want to pull it? They better figure out where they're putting the next line. Wait until an ICU patient dies because some nimrod pulled an IV and they can't get levophed/dopamine/dobutamine/blood they need to live -- but hey, the paperwork's in order.
Half the time you end up with beds that don't work or weigh the person on 10 mcg/kg/hr drips, IV pumps that alarm over nothing , short on nurses, short on supplies, Levophed on backorder, physically dangerous patient who need inpatient psych treatment, now thrown into ICU because nobody else knows what to do with them, but oh, yes, JC is harping on labeling IV sites, so let's focus on minutae so we don't have to look at the herd elephants in the room.
*sigh*
N2N, you NAILED it!!! :up: Makes me glad I don't work in a hospital anymore and that all I have to put up with are state surveyors who will hang a facility out to dry if the RN fails to write a wound assessment note at least every 7 days (forget the fact that she's responsible for 85 residents....).
I am a hard stick, a very hard stick, and if someone who wasn't my nurse was inspecting my IV and said it needed to come out because it wasn't labeled properly they better have a Dr's order to remove it.
A functioning IV is something to protect, not remove because of a policy.
This is an incredibly lame-brained, misdirected policy. If some incidents reports are written, that should suffice.
I agree about letting risk management know about this.
As I said many. many years ago, those that work Monday-Friday behind desks (referred to as M-F'ers) are often so insulated from reality that their policies sometimes don't make sense.
Who ever made up this one needs to be stuck unnecessarily a few times.
And if I was working and came across and unlabeled site, I would label it on the spot, and later discuss it with the appropriate person.
So what is the bigger infection risk? An unlabeled IV on a ill dialysis pt, or having to stick the pt 5 more times (and create 5 more holes in the skin) in one hour to try and get a new line?
Also, as a pt, I would be very uncomfortable if an unknown person came in to my room (even if they introduced themselves), checked my IV and then grabbed my arm to pull it out. Just thinking this is not such a good idea for those folks in administration...
I am a hard stick, a very hard stick, and if someone who wasn't my nurse was inspecting my IV and said it needed to come out because it wasn't labeled properly they better have a Dr's order to remove it.
A functioning IV is something to protect, not remove because of a policy.
This is an incredibly lame-brained, misdirected policy. If some incidents reports are written, that should suffice.
I agree about letting risk management know about this.
As I said many. many years ago, those that work Monday-Friday behind desks (referred to as M-F'ers) are often so insulated from reality that their policies sometimes don't make sense.
Who ever made up this one needs to be stuck unnecessarily a few times.
And if I was working and came across and unlabeled site, I would label it on the spot, and later discuss it with the appropriate person.
LET'S TRY TO BE KIND TO EACH OTHER!!!
I'm a tough stick too and I have a thing for good IV P&P. In fact when I've started new jobs, initially, I've been called the IV fairy, I then become the IV police, then, I'm the IV gestapo! As 11-7 supervisor/LTC,my staff got real good with PICC drsgs. Woe to them if I found undated sites and equip. And flushes left at the bedside!!! I don't want to hear "I didn't do it, it's from 3-11, I don't know,etc". I never wrote up my staff, but I did a lot of monitoring & counseling. After a while, they understood. After checking, I also made it a point to alert the appropriate shift supervisor/unit mgr (and the resp. staff nurse) that the problem was corrected. (And I love that M-F'er label, will add to my collection.)
:up: Makes me glad I don't work in a hospital anymore and that all I have to put up with are state surveyors who will hang a facility out to dry if the RN fails to write a wound assessment note at least every 7 days (forget the fact that she's responsible for 85 residents....).
turnforthenurse, MSN, NP
3,364 Posts
I make a habit to date and time an IV when I start one, but not everyone does. The little date/time sticker that comes with our tegarderm also doesn't always stay on...so I'm sure after awhile those dates/times just fall off. We have computer charting so when we chart a new IV, we also put the date/time it was started. If I don't see a sticker on the actual IV site, I'll do a chart check.
This just seems pretty unnecessary IMO.