Please stop! Little things that are just bad practice.

Loo17 · Oct 9, 2014

Just wondering...Are you talking about inpatient infusions of IV K+ or across the board it should be through a central line? I'm in the ED and we frequently give infusions of K+ peripherally, some of them are even discharged home, so it wouldn't make sense to put in a central line just for this purpose. Obviously if they can take PO that's preferred but sometimes we have pts with nausea/vomiting, or some kind of medical issue that they cannot swallow safely (OD, altered mental status etc), but there is no reason to place a central line.

I agree. Give it through a PIV often in the ED when a central line is not appropriate or an option. I do ask the provider (when the patient can tolerate) if we can infuse 1L with K+ versus the 100ml bag so it doesn't burn going in.

jordiRN · Oct 10, 2014

Leaving empty wrappers everywhere but in the trash!

Leaving in a PIV longer than policy because "it works fine" or the patient is a hard stick. At least TRY to get a new one started, or call IV therapy if you tried and failed. Don't just leave it for the next nurse to deal with.

Taking off my patients' BP cuffs and leaving them off when you leave the room. Absolutely take it off if you need to, but please remember to leave things as you found them! I have at least hourly vitals to get, and I don't want to miss a set for a silly reason like that.

TiffyRN, BSN, PhD · Oct 10, 2014

6. Most aggravating. Stop hovering over the toilet already. All you do is pee on the seat for the next person. For Petes sake your in a hospital there are much worse things you can get from a door knob.
Ok end of rant

We had people posting notes in our unit restroom about "be neat & wipe the seat". I then noticed we had one of those psychotic toilets that acts like it's flushing into the next galaxy. In this process it throws up sprinkles. I noticed because I didn't step away quickly enough and got splashed. So maybe no one was ever hovering, but the toilet was spitting.

Still gross, but, not my coworker's fault.

sistrmoon, BSN, RN · Oct 10, 2014

Leaving in a PIV longer than policy because "it works fine" or the patient is a hard stick. At least TRY to get a new one started, or call IV therapy if you tried and failed. Don't just leave it for the next nurse to deal with.

Our policy was actually changed from changing the PIV site every 4 days to leaving them in as long as they work and are not showing signs of irritation.

PMFB-RN, RN · Oct 11, 2014

Our policy was actually changed from changing the PIV site every 4 days to leaving them in as long as they work and are not showing signs of irritation.

There are still hospitals who change out perfectly good PIVs simply beacause they are 4 days old? What is like 1995? I wonder what the evidence behind that is?

AmyRN303, BSN, RN · Oct 11, 2014

There are still hospitals who change out perfectly good PIVs simply beacause they are 4 days old? What is like 1995? I wonder what the evidence behind that is?

If a PIV site is past the four day window, we are supposed to call the IV team to assess. Of the site is still patent, they initial and date it. The other day I had a fabulous site that was ten days out of date, but working well, and IV continued it.

amoLucia · Oct 14, 2014

Little bit late but just thought of this (another post about tx cart keys reminded me). THROW OUT any old leftover tubes of cremes, ointments, lotions, etc from the treatment cart when a pt is discharged. I know, I rarely ever went to the cart to ditch any old tx stuff when I discharged a pt. But when doing treatments and you note a med for a pt who has been gone weeks or longer THROW IT OUT.

Don't just look at it and put it back in the drawer!

As supervisor, I would sometimes 'audit' a tx cart and toss a trashbasket full of discharged stuff. And 11 bottles of opened and undated peroxide bottles, and about the same of little saline bottles and other liquids And there'd be a gazillion tubes of crèmes missing caps and squished empty or almost empty. I liked to do this right around survey time.

And unused but opened sterile equip. If you're not going to use the sterile cath tray after you opened it, just toss it. Don't stick it back on the shelf. Do you really think I'm going to use it?!?!? Do you?????

Replacement flexiflow Gtubes are a big waste due to this occurring.

Made me feel good about this vent!

jordiRN · Oct 14, 2014

Our policy was actually changed from changing the PIV site every 4 days to leaving them in as long as they work and are not showing signs of irritation.

Hey, I'm all for that! But that's not our policy, so we have to change them. Not trying to say it's best policy, just our current one...so it should be followed by everyone unless there's a documented reason why it shouldn't. It looks bad on me when I come in to find a 10 day old PIV and have to change it because none of my coworkers wanted to go through the trouble.

BlinkyPinky · Feb 8, 2015

These posts remind me of my 2 years on the hospital floor. Ah. Memories. ( glad it's behind me)

blondy2061h, MSN, RN · Mar 21, 2015

If a PIV site is past the four day window, we are supposed to call the IV team to assess. Of the site is still patent, they initial and date it. The other day I had a fabulous site that was ten days out of date, but working well, and IV continued it.

Our policy is to assess is q8h and as long as it's not irritated and flushes easily without burning it can stay in use. How often does IV team need to assess and reapprove the IV after the initial 4 day approval?

MjuneAlloiier · Mar 26, 2015

i've done this to protect me hands on dirt, but sometimes i forgot to change, and touch pt. with the same gloves on. sori

kool-aide, RN · Mar 26, 2015

I work in CCU and have vented pt all the time with OG/NGS tubes. I like to make sure the graduated cylinder and piston syringe we use several times a day to check tube placement, residual, and give Meds is changed daily. It just seems gross not to. They get kind of groady.