Submitted by DDavisCRNI, Clinical Educator, Omnicare of St. Louis on Tue Jan 10 14:08:16 2012
Can anyone help me with this question: Since the INS standards state to obtain a blood return from IV catheters, what does your policy say in referrence to short term, less than 3 inch peripheral IV catheters?
I realize that shortly after placement a small 24 gauge in a tiny vein of an elderly woman may fail to yeild a blood return due to vessel size, catheter size and fibrin buildup, BUT, does your policy state to remove and replace this small catheter if it fails to yeild a blood return at ANY time during its dwell? If not, how does your policy read? My concern is that each nurse doing this observation needs to be assessing for other s/s of complications since these catheters often end up without a blood return even in the first 24 hours. If a policy simply reads: "If a short term catheter fails to yeild a blood return, remove and replace" this will lead to unnecessary VP for the patient and a decrease in vascular access sites. Since it's a INS standard, and surveyors are citing these standards, how do you defend 'leaving a 24 gauge' peripheral IV catheter in if if fails to give a blood return shortly after insertion, but there is no patient complaints, swelling, coolness or any other obvious complications.
Thanks in advance for your time.