Nurses Safety
Published Jul 5, 2003
I have been assigned the task to determine what is the standard of how many IV attempts is appropriate for one nurse (ex. 2 attempts per patient is most common in my experience) anyone have any links or sites I can find validation for # of attempts?
traumaRUs, MSN, APRN
88 Articles; 21,250 Posts
I'm an ER RN in level one trauma center. For people who are not in full arrest or a bonafide emergency, its two sticks per RN. However, we have a huge number of new grads right now and I always tell them if they don't feel they can get it with two sticks, ask someone else to come and help point out spots. Also, please use EMLA on kids - no reason to torture children unless medically unstable.
Sarah, RNBScN
477 Posts
I try twice and get another RN for the 3rd hopefully successful attempt.
Check out the CINA web site for additional info.
bklynborn
196 Posts
2 here too
renerian, BSN, RN
5,693 Posts
WE did 3.
renerian
Burnt Out, ASN, RN
647 Posts
Our hospital policy states no more than 3 attempts per nurse...
Personally, I don't like to stick more than twice unless it is an emergency...
altomga, ADN, BSN, MSN, DNP, RN, APRN
459 Posts
At my facility it's 2 strikes and your out of there too!!
We also have an IV expert list that have nurses names and unit they work on so people know who to call (not that a lot of nurses like it b/c their name isn't on it and that pride ball of their's is too big to SWALLOW!!)
The nursing coordinator can be called also to get someone.. I often go start IV's and draw blood on other floors for people...
I happen to be DARN good at it, but suck at putting down NGT's!
Good luck:D
nowplayingEDRN
799 Posts
Originally posted by teeituptom Oh shuckins I never miss.
Oh shuckins
I never miss.
Don't brag too hard Tom.....there is a first time for everything......:kiss
Although I am one of the very few top IV starters in my facility...I do have my days and you know it will be one of those days when you use the 2 stick policy.
Anywhere I have worked: 2 sticks for RN#1, 2 sticks for RN#2, 1 stick for RN#3 and then call anesthesia....or the in house doc. I never try more than twice unless the patient begs me to try the 3rd time...and I do have 1 pt that comes in regularly for blood transfusions 2ndary to hemolytic anemia from being on nuclear subs during WWII.......he has had no luck with long term implantable caths and is a notoriously rotten stick. He asks me to try 3 times and then call anesthesia.
kimmicoobug
586 Posts
I don't think my facility has a rule about number of sticks. But, it is a general feeling here that each nurse should only get 2 sticks. We had a patient the other day with tiny veins. My preceptor tried twice, an OB nurse tried twice, and an ER nurse tried once. Then we called an MD, and he put in a central line
HousyHousy
4 Posts
At my hospital, we have an IV team whose job is exclusively traveling throughout the hospital to start IV's.... it's a wonderful help, but when they get backed up, it can take up to 2 hrs to get one started. For the floor nurses, it's general practice of 2 shots at a start. Most are afraid to call the docs for fear that the attending will send an intern (Yikes!)
toronto rn
91 Posts
2 attempts here and then either call another or the IV nurse, unfortunately the IV nurse doesn't work nights, in which case all the othere floors call us (MICU) to try. In an emergency the sky is the limit.
NotReady4PrimeTime, RN
5 Articles; 7,358 Posts
i'm not sure if our place has a specified limit. i try twice, then get somebody else. our patients cannot be without access so we will go down the line and after three people have failed, we get our attending to try.
aside from that, i personally have been jabbed 13 (yes that says thirteen) times by an anaesthesiologist(!!) with a 16 gauge because the iv started by the admitting doc wasn't "big enough". this man then proceeded to muck up my epidural and i ended up having a ga for my daughter's birth. bitter? just a teeny tiny bit!
VivaLasViejas, ASN, RN
22 Articles; 9,987 Posts
My hospital doesn't spell it out in exact terms, but if I can't get an IV in after 2 attempts, I call in another nurse. I also will not stick someone AT ALL if I can't find a good vein, or if they're a notoriously hard start---I'll try to get an ER or ICU nurse, or the supervisor to do it.
I can catheterize almost anyone, but I'm not nearly as confident in my IV skills, so I think it's only fair to the pt. to ask a nurse who's better at it to start the IV unless I'm reasonably sure I can get one in.
Just my 2 cents' worth.:)