Need Tips or Tricks on Remembering IV Stop Times

Nurses General Nursing

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Just wondering if anyone can help me and my fellow nurses on how we can remember to chart our stop times for fluids and ATB. We have a new computer system and there are so many stop times getting missed, and when we don't chart them the hospital doesn't get paid for them. Generally I am pretty good about it, but obviously others aren't because we are constantly getting nasty emails about it. We've even gotten screamed at and threatened to hold our paychecks over this issue.

So if anyone else has had to deal with this issue and has any suggestions for me, they would be greatly appreciated.:banghead:

Specializes in Labor and Delivery.

Wow, how can they hold your paychecks?!?! That sounds like crazy talk on their part!!!

What about bedside charting? Or taking the MAR with you when you start and stop the infusion, marking both times on the MAR?

Specializes in Developmental Disabilites,.

Huh we only chart our start time with the exception of blood products. What type of unit are you in?

Perhaps the computer folks need to make the IV stop times automatic. We don't chart stop times, and we're obviously getting paid since we haven't gotten nasty emails. I remember at some point somewhere, sometime, there was a thing about charting stop times and we (meaning*I*) made some comments about "If we don't chart that they stopped, does that mean the person is d/c'ed home with 57 antibiotics still running into the IV we took out when they went home? And are the insurance people too stupid to realize that if I run an antibiotic over an hour, it stopped around about an hour later?" Sometime, somewhere, someone came up with something to avoid the idiocy of charting stop times, maybe someone that does informatics knows what they do for that. If I had to chart stop times, as many other stupid things as I chart and hoops I jump through, THAT would be the one that would send me over the edge. I would quit and work 6-7x the hours at Taco Bell.

And I'd let them keep threatening your paychecks. Your state's department of labor would be quite interested in hearing about that...

Specializes in Cardiac, PCU, Surg/Onc, LTC, Peds.

I've worked for a hospital system that has the same procedure, to document IV stop times claiming they won't be reimbursed. In my current position at a different facility, this has never been mandated (except for blood products). I don't know why but it seems strange one system has to document times and another one has never brought up the practice.

I always wrote down stop times as we could go back in the EMR and backtime our stop times without consequence.

Specializes in ER.

Medicare does require a start and stop time for payment. Your charts may be audited by a charge capture analyst who is entering the assumed stop time in order to bill for whatever infused, however, they may also just send the claim without billing for the infusion and/or antibiotics.

So if an assumed stop time can be entered, why on earth should nurses that already have enough on their plates have to do it? Especially if it's a computerized system (as it sounds like OP's is.)

If we don't chart a stop time, it seems we should get reimbursed more for those IV antibiotics, since apparently they never stopped, it seems they should be getting a lot more money than for those ones we actually stop after 30 minutes or an hour.

We just had CMS come through our hospital not too long ago...nothing was said about charting stop times on IV antibiotics on our audits...and believe me CMS looked at EVERYTHING.

Of course CMS is hitting up a lot of hospitals this year...so I'm sure management everywhere is on edge.

Specializes in Cardiac.

Write it down? Lol

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Write it down? Lol

That's funny....:lol2:. Depending on how the billing is being processed is whether or not the IV needs to be documented at stop time. I have found IV's with a section on the MAR/EMAR works best.

At the hospital I work at, the approximate time that the infusion would be done pops up on the EMAR in red, requiring us to chart a stop time. It never gets forgotten because it is always staring at you in bright red until you chart something and then it will disappear.

Specializes in Oncology.

ahhhH!!! I just started at a new big hospital (compared to my awesome little 44 bed unit i moved away from =( and at this new hospital, they use Epic and I was just told today I have to go thru and put stop times for the same reasons, and cuz of something goofy with the I&O's (cuz most of the nurses don't actually CLEAR their pumps.. they just click the little button on the program that guesses how much has gone in based on the start/stop times)... And i have to put start/stop times for the IV pushes too! what the hell?! I have sooo much more little stupid pointless crap to do with this system, its driving me nuts... and ironically, my charting is WAY less thorough and detailed than it was with my old system.. when I could put a freaking nursing note in... grr...

so yeah, anyone with stop time tips for meds you don't have set to yell at you when the Abx is done? cuz I personally hang too many damn piggybacks at night...

its a computer, make it do the math! Or even give you an "estimated stop time" and a little box i can check to say it was right or i can change it?

stupid crap.

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