Midline Orders

[MikeyT-c-IV]

I'm curious what other places are doing in regard to midline orders. I'm using a Bard Powerglide and the Angiodynamics Bioflo midlines. As of now we require an order to place a midline. We do not require a signed consent from the patient.

I'm wondering if anybody has a nursing protocol or policy that allows you the freedom to choose if you need a midline without needing to contact the physician for an order.

I know of a hospital in my area that does have a policy in place but I'm having a hard time getting a copy.

Thanks.

[UnbrokenRN09, BSN]

Our facility doesn't require a physician order for a midline and we use the bard power midline product, which is basically a short picc line and is put in the same way. The reasoning behind that is it's not entering the central vasculature, so risks are similar to that of a regular IV. We also don't use them to infuse vesicants long term and never tpn. If they end up needing a PICC later we do a guidewire exchange as long as there are so s/s of infection of thrombosis.