Heparin safety

[mgaynor]

Do any other hospitals use a two RN check for IV Heparin administration? If you do is it a policy or a recommendation? How detailed is the process? How is compliance monitored?

[billythekid]

2 RN check for heparin infusion... doctor order sheet must be double signed, then two initials required on separate Heparin MAR to document initiation, change of rate/dose with PTT recorded, and each time bag is changed.

No double check for Heparin SQ -- standardized 5000 Unit vial.

Also, we only do saline flushes..

[KaliNurse]

Billythekid,

It seems like you are talking about a Heparin drip, not Heparin SQ. A double RN signature is a mandatory policy in each facility because Heparin is considered a "high-risk" medication when given via IV route......just as an insulin drip would require a double RN signature as well. I have never heard of a facility not mandating a double RN signature for Heparin IV. It should be mandatory in each facility.

Hope that helps!

[billythekid]

Billythekid,

It seems like you are talking about a Heparin drip, not Heparin SQ. A double RN signature is a mandatory policy in each facility because Heparin is considered a "high-risk" medication when given via IV route......just as an insulin drip would require a double RN signature as well. I have never heard of a facility not mandating a double RN signature for Heparin IV. It should be mandatory in each facility.

Hope that helps!

My facility does not require double RN signature for Insulin drips, so I didn't take it for granted that Heparin was double-signed at every facility....

[KaliNurse]

Well, I guess I wouldn't take that for granted either. But, think about it....that makes NO sense. Why would the facility require a double RN signature on a heparin gtt and NOT on an insulin gtt???? I can see why you are questioning it!!

[ayla2004, ASN, RN]

don't see iv heparin as rehab unit

no doubkle sign required for lmwh or warfrin but this may be changing as identifed as high risk. lmwh in pre filled syringes mainly for prevention.

insluin tends to be checked dose but not double signed.

we onlu double sign opiates/blood or stat dosses

[OldnurseRN]

Our facility requires two signatures on heparin but only one has to be the RN. We don't always have a second RN but our LPNs can witness.