JLS21686

Can I ask, in your previous experience, did you have an actual policy that stated to adjust the weight based medications according to the daily weight?

I work on a cardiac telemetry unit. The admitting diagnosis and/or past medical history for the majority of our patient population is CHF exacerbation. Typical admission stays can be anywhere from 5 days to weeks/months. In that period of time, as a result of major diuresis, patients (upon discharge) can weigh 20-40lbs less than when they come in. We administer weight based medications, such as dobutamine (mcg/kg/min.) and adjust the weight in the IV pump every morning based off of their daily weight. My coworker and I are working on a policy for dobutamine infusions, but are getting backlash from the ICU. The ICU bases their dose of dobutamine off of admission weight, and does not change that weight unless there is a significant loss of weight (i.e. Amputation of a limb). The ICU was also concerned that staff on our floor will cause medication errors when adjusting the IV pumps, even though 2 RNs double check the weight and the pump. We believe that our way in the acute care setting is best because of significant drops in weight due to diuresis, and much longer lengths of stay. Any thoughts?