TECHS VEIN LOCKING

Tait, MSN, RN · Jun 4, 2009

At our facility a tech can remove an IV of a person leaving, however we always do everything else with the IV, from correcting a beeping pump to heplocking them for transport or a gown change/shower.

I would assume the logic is as follows: INT's should be flushed when disconnected from the patient, and a flush is considered a medication by most facilities, thus only being within the scope of practice for a nurse to administer.

Tait

ohmeowzer RN, RN · Jun 4, 2009

at the hospital i work in only the RN's ( we don't have LPN's) are allowed to heplock a pt's iv. we had a CNA do that once about 4 years ago and she HL'd a pt's iv and the pt was on a heparin drip. the CNA was fired and reported to the board for working outside her scope . i don't like anyone messing with heplocks but me or another nurse. i put them in and only i should unhook them. i agree with the RN if the pt has TPN or a heparin drip or another medication that can't be unhooked from the line, and a tech does this. there would be serious trouble. i don't like people to touch my iv lines or pumps.

cardiacmadeline, RN · Jun 4, 2009

We are supposed to scan saline flushes into the computer every time we flush an IV, so technically it is a medication, which only nurses can administer.

Dionyonce · Jun 4, 2009

Ok so y is this scope different in emergency dept...there techs put lines in...put cathers whereas this dept u can't.

I feel like if its gonna be a new quote n quote law....then it should be the whole hospital...because now when a tech floats n is ask to do a task...Now what should be

said" I'm not allowed to do this even tho the techs in your dept are allowed to.."

chenoaspirit, ASN, RN · Jun 4, 2009

Its the same here. Only an RN/LPN can flush an IV because of liability issues. There is too much risk. Thats the rule in the entire hospital, but floor managers in the ER and ICU allow the techs to even though they arent supposed to. But they teach them to do so (even though they arent supposed to), they trust them. These same techs knew the same rules didnt apply to the other departments and didnt DARE try it if they were pulled to our dept. Honestly, I didnt want anyone touching my patients' IVs except me because they were under my responsibility and I didnt want any "accidental" flush of something other than saline. It can happen. Now I work homehealth and dont have to worry about it.

TiffyRN, BSN, PhD · Jun 4, 2009

Keep in mind that RN's & LVN's (LPN's) have different scopes of practice in different states. Also different hospitals interpret the Nurse Practice Act of their state differently. Most States do not spell out each and every task of each level. A hospital I worked for in Florida had LPN's drawing blood and flushing central lines after specialized training. The hospital felt it was in their (the LPN's) scope of practice. Then the state board got word of it and informed them they disagreed and that LPN's should not do anything involving a CVL, they couldn't even reset an alarming pump if it was going to a CVL. I've worked in 3 different states and all 3 interpreted the scope of practice of LPN's (and a few differences for RN's).

For the most part I would say no hospital has ever permitted CNA's, tech's, non-licensed nursing personnel to touch IV's except to D/C them per the direction of the supervising nurse. No matter how rushed the nurses are, how overworked, if the individual is not a licensed nurse, they don't touch the IV pumps, much less flush the lines. That actually gives me the shivers. Too many factors to be understood, If the antibiotic finished running, is a dobutrex drip running (I've worked regular medical floors that had them running at lower rates like 5mcg/kg/min), did they use saline?

I did work in a hospital that allowed their ER techs to start and flush (with saline) peripheral lines, but they had to also be certified paramedics first and they do have sufficient training due to that to make me very comfortable.

There are things I am not permitted to do in my current State as an RN that I was not able to do in another State. So check your local State Board to make sure you don't do something out of your scope of practice. Just because it's always been done, or they do it on another floor will not hold water when you are called to the Board to justify your actions (and perhaps denied access to advance your scope of practice to RN or LPN).

shiccy · Jun 4, 2009

I shiver at the thought of a UAP doing anything to my pumps, but have had a few silenced from time to time (even though it's not suppose to happen). I've had to remind a few UAP/NA's to not touch IV pumps. I actually once even saw an IV pump settings completely erased due to errant UAP button presses.

The other concerning thing is this: We have had things like hand washing, alcohol pad use, etc BEAT into our skulls from anywhere from 2 - 4 years. The UAP's training is more like 1 - 2 months ... Just the infection risk alone is enough for our hospital to say, "You can technically take them out, but we would really rather a licensed person do that".

Finally, per state protocol, our UAC's *are* permitted to place & remove urine foley catheters - the UAC's per HOSPITAL protocol, however are only allowed to remove them.

chicookie, BSN, RN · Jun 4, 2009

I love my techs but do not want them to do ANYTHING with my IVs. I had one try to disconnect the patient so the patient could take a bath, removed the whole IV.

and it was a hard stick too! Not fun at all!

Plus, well I suppose this is partly my fault. They have clamped the iv without flushing it, the patient takes a shower, eats, the goes for an xray. IV clots. yay.

I rather do it all even if it takes more time b/c that way I don't have to stick them again.

NurseLite · Jun 4, 2009

I have five simple words for my techs: "Please don't touch my lines" . While I value the work my techs do, I certainly don't want them to do anything outside their scope ... not only is it their a$$, it's my license on the line.

Dionyonce · Jun 4, 2009

Chenoaspirit....thats interesting techs floats to another dept. and DARE's not to do the same thing or even think they can...never thought about it that way....

Medic09, BSN, RN, EMT-P · Jun 4, 2009

Of course, it all comes down to local scope and/or institutional policy. But there isn't any reason that a tech can't learn to safely work with an IV. Outside the hospital, EMT-Intermediates start and use lines all the time. In some places, like Israel, every EMT can start and use a line. Techs can certainly be taught to safely work with a line, if that is what is wanted.