pediRNCHAM

It's fascinating to learn about the what is customary practice in other countries. Joint Commission and sentinel events at several hospitals in the US involving problems with RNs adding K+ to IV's has resulted in it being removed from stock on nursing units in both the large NYC hospital where I know work and the much smaller community hospital where I previously worked. It is not a matter of adequate pharmacy coverage, it's a matter of retaining your accreditation and licensure. This has all occurred in the northeast US in the past four years. So this is a fairly recent change in practice. But getting back to the Pedi question: the answer is "pee" before KCl.

First - No RN's add KCL to IVs. All KCL additives are done by the pharmacy (You'll get a Type 1 citation from JCAHO if you've got KCl on your units!!!). As far as clinical assessment of the pedi patient before having IVF w/KCl, patient needs to have voided before hanging the K. Renal function needs to be validated before using KCl additives:D

I am updating my Pediatric P&P Manual for JCAHO review coming soon in December. I would like to know policy on other peds units/hospitals on frequency of weighing infants and children on acute care units. Our currently policy has us weighing every infant