I need some feedback. We have a new infectious disease doc. who does not believe in placing a central line for a 7-10 day IV antibiotic therapy because of the DVT risk. We administer a lot of vancomyacin in the home (always through a CVAD). In the hospital they administer it in a PIV (which I do not like) but those patients are not moving around like patients in the home, the nurses are able to assess frequently. I can see some major injuries and more frequent nursing visits occuring if we give vesicants in the home. Am I being overly concerned? Have any of you been in this situation that can share outcomes with me that I can take to the doc.?Thanks, Valorie Dunn, BSN, CRNI
The discussion about midline catheter and the appropriate types of infusates for them began a few months ago and kicked into high gear at the recent AVA conference. I think those presentations only caused a lot more questions to be asked and many are still confused about these issues. I was part of the original group that introduced the first midline catheter to the US market. I am very familiar with all of the published literature, good and bad, about midlines. I have gone through that literature with a very critical eye. We are offering 2 types of online presentations that address these issues.
You can take our online CE course on Midline Catheters: What, Why, and When - Lynn Hadaway Associates, Inc. Just click the title to go to the website for learning objectives, etc.
On Oct. 16 at 1 pm, I will offer a videoconference to continue the discussion started at AVA. Midline Catheters for Vancomycin Infusion - The Discussion Continues - Lynn Hadaway Associates, Inc. Again, click the title to learn more details.
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
Thanks Lynn. This doc. means a short PIV not a midline. Valorie
Valorie Dunn,BSN, RN, CRNI, PLNC
I think it is unreasonable to expect 7 to 10 days of vancomycin through a short peripheral catheter, but that depends upon the number of veins each patient actually has available. If I were a patient, I would not allow it but patients don't know their options. In situations like this, I have educated the patient about their options and then empowered them to decide. If they refused what the doctor ordered, so be it. That prescriber would then have to make another choice. One way to do an end-run around the prescriber when they will not listen to you. 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