Posted this topic yesterday, but want to add more specficity. I work in a hospital with two very busy 45 bed telemtry units, at this time the unit nurses are expected to start/restart IVs with IV Team acting as a back up. There have been some patient satisfaction issues due to multiple sticks and painful starts by the unit nuses. In a few weeks we are going have 16 new RNs starting orientation on one of the two telemetry units and we are trying to decide whether or not to inservice these new new hires to starting IVs -There are differing opinions about the issues involved -patient satisfaction, response time, overburdening an already overburdened IV Team. Some feel that IV Team should be doing all starts and restarts and others feel that the telemetry unit nurses should be responsible for IV starts/restarts on their patients with IV Team acting as a back up.
We are interested in hearing what other hospitals are doing and the rationale behind policies.
Thanks Again -OGM AGH Pittsburgh, Pa
I think the key phrase you mentioned in your question was "overburdened IV team". If IV is overburdened, then response time is going to be an issue. A delayed respone time on a cardiac unit is dangerous when the staff nurses are unskilled in placeing peripheral lines on thier own. This is a tough issue. On one hand, a dedicated IV team starting and maintaining peripheral IVs has been shown many times to have better patient outcomes, and a better overall patient experience. There are plenty of studies publish to show that. On the other hand, taking this task/skill/responsibility away from the primary nurse on the unit leads to a culture of complacency and ignorance about the care of the IV's. I think all nurses in acute care areas should be able to start an IV in an emergency, and that becomes less likley when IV teams cater to these units.
I think ideally, dedicated IV teams to start and restart all peripheral lines and to do central line dressings, declotting, troubleshooting, removeal, is ideal. But for it to be successful there needs to be a committment to a well staffed and supported IV team. That can be tough, especially in this economy where management is looking for places to make cuts. IV is often a target.
If your IV team is overburdened, adding tele units as full time service will not result in good outcomes. If adding staffing in IV is not possible, i believe it is best to maintain this as a primary nurse function. Tele units have a lot of IV restarts. Medic lines that need to be replaced(dirty), ER lines that are always in the AC and sore or occluded, multiple lines for IV drips, very demanding on time.
hope this helps.