patient leaving with iv lock in place

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we are having a number of patients wanting to leave with their IV llocks in place. most are known drug users and they are leaving AMA. i would like to know what is my legal responsibility? can i let them go? am i responsible if they use it illegaly or come back in with a raging infection? most are so belligerent that we let them go and hope for the best. we are a smaller state that is seeing a lot more of this everyday. this is a growing concern to the nurses and would like to know how other places have handled this situation.

thanks

ellen in maine

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Specializes in Critical Care.

Wow! Never had that happen! I would think it has to come out. Of course if the patient is going to hurt you for trying to remove it it's another story.

I'm interested in seeing how everyone responds.

Noney

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Specializes in Critical Care.

I would tell them that if they leave the IV comes out, if they threaten you then call security and the police. Make a list of who they are and if they come back in the doctors need to be made aware of this and order po or IM meds.

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Our policy is to remove HLs before discharge. I PRESUME you can't touch the patient unless he allows it, otherwise it's battery,right? Document EVERTHING to CYA.

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Specializes in Med-surg; OB/Well baby; pulmonology; RTS.
Originally posted by redshiloh

Our policy is to remove HLs before discharge. I PRESUME you can't touch the patient unless he allows it, otherwise it's battery,right? Document EVERTHING to CYA.

I agree-if they refuse for the heplock to be removed-then what can we do? They have that right :o I would be sure to notify these patients' doc.....

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If the patient refuses to have his/her IV removed your only option is to call security. I have seen this happen at the hospital I work at. Definately document everything and inform the physician.

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At an ER I worked in recently (small county hospital), we had "revolvers": patients who came back to the ER on a schedule (Q8, Q12, QD) for IV abx. The HL (okay, I know they are now called saline locks, but I am old!) stayed in. It was flushed, and covered with kerlix and a net stocking. It was easier for the pt - they did not need to be "stuck" every time they came in.

There were some pts (they were usually there because of dental pain, ie - infected teeth, dentist wouldn't touch them; WE knew it was because of meth use!!) that we worried that they would use it for "other" uses when they were away from the hospital.

In the 6 months I was there, though, no one came back as an OD!

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The IV access has to come out before they leave. If they don't allow it, then call security. There must be a way to screen patients that are known IV drug users ad then don't place one. PO or IM meds for them. Documenting everything is imperative.

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Specializes in Med/Surg, Geriatrics.

In addition to what everyone else has written here, you also need to notify risk management of what is going on here.

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Interesting thread. What is the association between meth use and infected teeth?

I haven't seen any patients wanting to go home with their saline lock in.

This thread sure makes me recalculate my image of pristine Maine.

LOL

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Rotten teeth in young people (

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In mental health, people sign "suicide contracts" saying they won't harm themselves for the next 48 - 72 hours, if they feel the need to, they will contact their counselor. This supposedly frees the mental health unit from liability if the pt. leaves the ward and then attempts (or succeeds) suicide. Is it possible that these problem patients with IV's could sign a contract on admission to the hospital stating they will not leave before the IV is dc'd - would that release anyone from liability if they did in fact refuse to have it taken out before they go - or sneak out, as I've had happen?

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