Surgery Center cuts IV lines

[rovergirl]

I recently began working at an outpatient surgery center and discovered their practice of cutting the IV lines when the patient is getting dressed to go home. They do this to save money and not use "j-loops" or "buff caps". So the IV is clamped and cut about 4 inches from the insertion site. I am appalled and won't do this. Has anyone else seen this practice done?

[mcknis]

What? That is rediculous! why not just remove the IV before they get dressed? I don't think I understand why this would be done.

[rovergirl]

They want to keep the "IV" in until the patient is wheeled out the door.

[cardiacmadeline, RN]

I'm confused. After you cut the IV, isn't it useless anyways? This is one of the strangest things I have ever heard. I would refuse to do it too.

And what do they use to cut the IV, sterile scissors? I can just picture all kinds of bugs and germs crawling into the line.

[prmenrs, RN]

Violates the laws of Common Sense, if nothing else. If they're recovered enough to get dressed, they shouldn't need the IV. If they need the IV, don't get them dressed.

Crazy. jmho

[mamamerlee, LPN]

I don't get it. Don't they remove the catheter before the pt leaves? What is the point of cutting the line? Sounds weird to me!

[fiveofpeep]

I had the scarring experience of accompanying my histrionic best friend to outpatient surgery and the PACU RN left the IV in till the end because of liability more than anything else. so they have a line just in case

cutting the IV is not cool though

[GilaRRT]

Strange?!? Why not place a saline lock, turn it to a running line in theatre, then back to a medlock until the patient is discharged. Quick, easy, and no...cutting needed.

[lifetimern]

This whole idea that the patient has to have their IV in place until they are, literally, being rolled out the door is more common than you might think. I've never heard of a place so cheap that they won't spring for a saline lock though! I agree, I wouldn't cut the tubing. I would simply remove the IV right before the patient got dressed to leave as others have suggested. If the people you are working with are freaking out because you are removing the line too early, you could always just thread the tubing through the patient's clothes as they dress, leave the line in place, and thread the tubing back out the patient's sleave (with the end clamped and wrapped in an exam glove) when the patient leaves and you d/c the line. Or, you could tell your co-workers that laws governing malpractice and liability, while sometimes impractical, weren't written by chimpanzees. Tell your collegues that removing the line shortly before the patient gets dressed in anticipation of discharge shows prudent judgement with little chance of legal exposure.

[NurseKJ]

If a patient were to truly need an IV line right before discharge, wouldn't it be more a liability to have an IV line that has been cut? And what about the patient who gets septic from MRSA and sues because the MRSA's entry point was via a contaminated IV line?

No IV or IV with line cut and contaminated; still both going to need to place a new IV in the emergency situation.

Does the manager, physician, or IV therapist in the hospital aware of this practice? I would ask.

Anyways, just my two cents

-KJ

[NotReady4PrimeTime, RN]

First let me say that I would not be cutting the line, as everyone else has said. The rationale makes absolutely no sense.

Second, let me assure you that there are odd practices that happen everywhere. I work in a pediatric ICU where 97% of our patients have both central venous lines and arterial lines in situ. When they're ready for transfer, there's often a holdup due to lack of space on the floors, so they get to spend another night (or five) on the unit. The orders may have been written and the patient deemed ready for transfer, but the nurse better not even think about d/c-ing those lines until s/he can see the whites of the ward nurse's eyes! It's stupid... we have to leave an art line in a kid who is sitting up playing video games and eating spaghetti. I know there have been issues in the past with hemorrhage because the art line was d/c'd in a rush to get the kid out because now there's a kid in ER that HAS TO COME NOW AND YOU HAVE TO TAKE IT!... so the proper attention to hemostasis is not there. Ward nurses don't usually think about checking a pressure dressing frequently for a few hours because that's not in their repertoire. It's just dumb, and dangerous.