patients leaving with IV lock in place

Scis · Sep 8, 2003

I work in an inner-city ER where it is an addict's dream to sneak out with a heplock in place. I'm sure you are required to document in your notes that a heplock was removed (assuming that the documentation noted it's placement!) prior to discharge.

Of course some liability could ensue if you knowingly allow a patient to leave with such a device in place. Cellulitis, etc. can occur if they use the site for IV drug use.

If they happen to leave without you noticing and you believe the heplock is still in place, document,document,document...Also in our institution an Incident report is required.

I find it hard to believe that they would actually tell you that they are leaving with the device in place and they are allowed to do so...the device is required to be removed prior to discharge. Many of my patients, if they are leaving AMA, yank the heplock out themselves.....either way, if it is left in or they yank it out, CYA and document!

Patty

Teshiee · Sep 8, 2003

Sounds like drug addicts does this what would an average person want an IV left in them for? Incident report document document document.

AMV · Sep 8, 2003

We have one drug seeking "frequent flyer" who insists that she doesn't have any viens left (she does!) and should have a central line or mediport placed!! LOL!!

Nothing wrong with her... she is in her 30's. We have several that do this - and we aren't an inner city hospital, but way out in suburbia. All they have to do is come in complaining of chest pain and - voila - chest pain (cardiac) orders include good ol' morphine... they get a night stay in PCU until - once again - until cardiac enzymes come back negative x3, etc. and they've ruled out the MI. Amazingly they have this chest pain which seems to reoccour every 4 hours (although the orders WOULD allow it every 5 minutes!) and this pain magically disappears as soon as it is time to go home. All at the expense of the hospital, since they don't have insurance.

pinkfloydfreak · Sep 8, 2003

Pain is subjective. It is what the patient says it is; there's nothing we can do about it or, is there?Document, document, document.

casper1 · Sep 8, 2003

In New York I've been told it is a state reportable incident if a patient leaves the hospital with a peripheral IV inplace unless a MD has specifically requested it be left in.

Sarah, RNBScN · Sep 8, 2003

We send pt. home with lock in situ...they are on QID or TID antibiotics and come back to ER for the tx. Regardless if they are IV drug users or not, they'd inject anyway and anywhere whether the lock was there or not.

Just my two cents...

Sarah

AlabamaDesigner · Sep 8, 2003

I am a patient that over the years has been in hospitals way too much and the part I hate most is having the IV taken out...I would love to just leave it there, mom is a nurse and so won't let me do that. She once had a patient leave with the lock in place and she went and chased the cab they were in down

dazed&confused · Sep 9, 2003

We had to attempt to overhead page x3, report it to our nurse manager, write an incident report. Of course, we documented every step. If unable to locate, then we attempted to call any known number and document the response. I HATED for someone to pull that stunt cuz of all the extra work! heh

debbyed · Sep 12, 2003

If a patient states they want to leave with a med lock in place, first we inform the patient why that isn't allowed and then we tell the patient that if they do leave with the med-lock in place we will notify the police and have them returned to the ER for removal. That's usually enough to change their minds. And yes we have had occasions when we have called the police on the basis that the med-lock is hospital property. Since word has spread in a "certain community" that we will involve the police we seldon have a problem any more.

In the event that a med-lock is accidently left in we continue to call the patient until contact is made. If the patient doesn't have a phone, again we will send the police, not to bring them back but to have them contact us so arrangements can be made to have the med-lock removed.

Rena RN 2003, RN · Sep 13, 2003

If a patient states they want to leave with a med lock in place, first we inform the patient why that isn't allowed and then we tell the patient that if they do leave with the med-lock in place we will notify the police and have them returned to the ER for removal. That's usually enough to change their minds. And yes we have had occasions when we have called the police

same for our ED.

mommatrauma, RN · Mar 7, 2005

It's a reportable incident for us...we have to notify the police...They make every effort to locate the patient and make sure its out...If its still in...they bring the patient back and we take it out.