KVO rate

Specialties Infusion

Published

I was asked this morning if KVO and/or TKO rates are still acceptable abbreviations by JCAHO. I hadn't heard that they were not.....does anyone know for sure and what standard applies to this?

Also, we use 30ml/hr as a KVO rate. Is this accurate? I couldn't find anything in the INS policy and procedure book.

Thanks.

Specializes in critical care.

This link may help ...

http://www.jointcommission.org/AccreditationPrograms/AssistedLiving/Standards/FAQs/InformationManagment/Planning/abb_list.htm

Also, when I did my hospital orientation, we were told that our Alaris pumps should be set to 0.5 cc/hr TKVO (I checked the Alaris website and the newest pumps have a KVO button / soft key that delivers 0.5 cc/hr).

EMS often come into emerg. with 10 gtt/min sets running by gravity, and their KVO rates are sometimes about 100 X higher (~ 50 cc/hr) than our pump KVO rates, but since rates fluctuate when an IV is running by gravity, and there are no alarms, etc. 2 drops in 15 sec (~50 cc/hr) is what we've been told is an acceptable KVO rate with such sets ... can't find a reference. We switch to a pump or 'take down' and saline-lock these lines. I don't work peds ER much (I've done maybe 10 shifts there including 3 buddied shifts), but I've seen the 24 ga angiocaths hep-locked by the "peds. core" RNs. Anyone know how long a S/L'd 24 ga will last before needing to be flushed? Is it not safer to use an Alaris pump at .5?

FYI, I also work in Neuro ICU where some RNs still use saline drives (i.e. NS Y'd in with a slow-running med line) to maintain patency of some drips (e.g. insulin 1u:1cc, which we always double-prime because insulin binds to sites in the lumen of the tubing), but our clinical educator says our pumps don't need "drivers" and can be run as low as 0.25 cc/hr.

Specializes in Clinical Infusion Educator.
I was asked this morning if KVO and/or TKO rates are still acceptable abbreviations by JCAHO. I hadn't heard that they were not.....does anyone know for sure and what standard applies to this?

Also, we use 30ml/hr as a KVO rate. Is this accurate? I couldn't find anything in the INS policy and procedure book.

Thanks.

Kathy76,

Like many abbreviations, KVO can be problematic. KVO can be 0.2cc/hr or up to 50cc/hr. Normally, unless the facility that you work for has a set flow rate for what KVO is for that institution, you shouldn't accept that abbreviation as an order. ie. Dr. states or writes, "decrease IVF to KVO" without having a specific P&P in writing for your facility, pinpoint that MD.. "Hey doc, can that be 5 or 10cc/hr?" then write the order clarification to reflect that.

DD

According to INS' latest Infusion Nursing Standards of Practice Jan/Feb 2006

Standard 9. Physicians or Authorized prescribers order and initiation of therapy.

* 9.6 Prior to initiation of therapy, a Keep Vein Open (KVO) order shall contain a specific infusion rate.

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