standard of how many IV attempts

[megpwh]

I have been assigned the task to determine what is the standard of how many IV attempts is appropriate for one nurse (ex. 2 attempts per patient is most common in my experience) anyone have any links or sites I can find validation for # of attempts?

[Nurse Candy]

O.K. I have a question related to this one. I am getting back into nursing after 15 years out of it. I am in home health. I have tried twice now (two times each) to draw blood on little old ladies, and I have been unsuccessful each time. Where does a rusty old nurse go to "relearn" the knack I seem to have lost, without torturing my lovely old patients?

Candy

[AnnieMarie]

For guidelines regarding IV pokes--I'd look into the Intravenous Nurse Society and Oncology Nurse Society guidelines. I think that these would be the standards we would be held to in court. I would also consider how many pokes you feel comfortable charting because the attempts # & sites need to be documented.

In general, I only stick a vein where I think I have greater than an 80% chance of getting the vein, so I might try anywhere from 0-2 times based on their veins & the situation.

I have found that little old ladies & men can have such fragile veins that sometimes using a snug (but not tight) tourniquet for a very short time works best. Be sure to really anchor the vein with your other hand to prevent vein movement.

I think the best place for the home care nurse to get experience is to go to a lab and draw blood all day. If that isn't possible, I'd go out with another nurse who has a lot of experience and a lot of lab/IV starts that day & let her/him train you and give you pointers while you do it. Make sure the catheters you are using have sharp needles--sometimes its the equipment that is the problem not the professional.

I have found that I could not start an IV very successfully if I WAS Hypoglycemic or dehydrated!!

I wouldn't give up on hot packing. We had all our pregnant dehydrated ladies (home care) with hyperemisis take a shower before we got to the house. This would make the difference between 1 stick versus 2 or 3. I also think the hot packing helps the person to relax.

Annie:cool:

[storey]

Our facility has a 2 stick limit times 2 RN's. We then call anesthesia.

[healingtouchRN]

I took an advanced IV course with a nurse who help write these guidelines, more than I ever wanted to know about IV"s! Expensive but worthwhile manual to purchase for a department.

[kmrmom42]

Originally posted by Retired Nurse

Just say a quick prayer to St. Anthony. He helps find things. Including veins.

It is funny you say that because a few of my colleagues like to start IV's on their knees and they always joke that their technique is to "pray" the angio into the vein!

We usually follow the unofficial 2 stick rule as well although once in a while we might try three if we are sure we can get it on the third.

When I was new at IV's I would only try once, no point in torturing someone with my inexperience! Now that I am pretty good at it I will usually go for two and will almost always get it in. I don't have as much success with neonates but they are a lot tougher.

Karen