In this week’s “Ftag of the Week” post on the CMSCG Blog, we’ll finish our review of F694 Parenteral/IV Fluids with some important reminders from CMSCG Clinical Consultant Mary Quinn.
Maintenance and Discontinuation
Don’t forget about these:
- Arm circumference and catheter length should be monitored when a PICC line is in place. Documentation is often lacking in this area.
- IV antibiotics typically are ordered with a time limitation. After the medication is completed, make sure the catheter is also removed. Many times, a hep-lock has been observed in place significantly after the medication has ended. If a catheter remains in place after fluids/medications have completed, there should be documentation of the continued rationale for the device.
- Follow your own policy! i.e. who can remove a PICC? Is a chest x-ray needed? Is it documented that the entire catheter length has been removed?
Prevention of Infection
The Interpretive Guidance in Appendix PP includes a list of infection control areas that may need monitoring:
- Appropriate hand hygiene is completed during all aspects of IV therapy
- Saff use aseptic technique when placing a venous access device
- Appropriate antiseptic use is in place to scrub IV ports, needleless connectors, and hubs prior to access or use
- Appropriate use of PPE, which is based on potential for exposure to blood, bodily fluids, and infectious agents
Competencies
Once again, this is a reminder that’s certain competencies are really important, especially the list below:
- Include use of infusion equipment – pumps
- IV insertion – as indicated
- Monitoring/assessing for complication
If you make a decision that your facility will be providing IV therapy to those residents who require it, you need to ensure that you have appropriate, comprehensive policies and procedures in place as well as a knowledgeable nursing staff who are not going to serve you up a deficiency for poor practices being identified during survey.
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