In an ambulatory post-surgical area, when converting a continuous infusion to a saline lock (temporarily before D/C) do you obtain a physician's order for the saling lock and flush? The rational is last nausea while ambulating requireing medication or fainting, pain, .....
My experience comes from a hospital setting where the IV team serviced all areas. We had a policy and procedure for flushing and locking all types of catheters. The LIP prescription simply stated to convert to a lock or when taking po, convert to a locked catheter. There was no further orders required for what solution was used to flush and lock any type of catheter. This was determined by hospital policy and procedure that had gone through the appropirate committees. It is far too confusing to have each LIP prescribing different solutions for this purpose. Many times, the nurse is making the decision that the fluids can be stopped. If the nurse makes that decision, he/she can also follow p&p for the flushing and locking solutions required when the VAD is converted. Having nursing own our infusion practices is a very important issue for me. This is a specific practice that is within our domain to decide and I think nurses need to avoid over-reliance on requiring an LIP order for everything. I am not aware of any state rules or regulations that would require this, with the possible exception of home care. And I think that has more to do with reimbursement than the legal scope of practice for the nurse. Someone correct me if I am wrong on the home care stuff! Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861