I had an order to start a continuous furosemide infusion. My specific concerns were that the patient was not on any form of monitoring and that the initial dosage seemed to be rather high.
In every other facility I've worked, med/surg patients on these drips were required to be placed on remote tele, and there were also specific policy guidelines regarding how often to monitor VS, weights, I/Os, and labs. There were also guidelines as to the initial dosage and rate of titration and these rates were calculated on the patient's dry weight.
None of this existed here. In fact, when I questioned the chief pharmacist she stated that although "we've talked about it", the hospital didn't have a policy on continuous Lasix infusions (there was even some initial confusion as to whether pharmacy or nursing mixed the bag). In response to my questions about the above monitoring (other than tele--- this floor wasn't set up for tele), the answer was a vague, "well, we will watch her closely" followed by an admission that there were no guidelines for doing so. The starting rate of infusion was much higher (about 3 times) than I've seen used in the past, and the answer to my question on this was simply, "yeah, that's pretty high, but the patient has received intermittent bolus doses".
I'd like some input from others here regarding their hospitals' policies on these infusions. I tend to be a pretty easy-going person, but this just seemed wrong on so many levels.
