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IV chat 11232010

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IV chat 11232010 IV chat 11232010 Document Transcript

  • Welcome everyone to IVchat! Let's begin with intros, tell us about urselves in <140! #IVchatIVchatMorning all (my time) Glen, NUM - Day Oncology Unit, Brisbane, Downunda. Wed 11 am here, working, full clinic, may be in and out #ivchatchemosabeGood to see all - Vernon in New Orleans - Critical Care, Nursing History and Hospital Nightmare :) here it learn from #IVchatnursingpinsHi all, I'm Cora, infusion nurse and moderator for IV chat! Welcome!! #IVchatInfusionNurseI'm Crystal - I do social media for the NursingLink community! #ivchatNursingLink@chemosabe Hi Glen, thank u for joining ur first IV chat. we're so happy u can join today! #IVchatIVchatHi! I'm Teresa, from Long Island, NY and a staff development instructor #ivchatNurseEducator@NursingLink Welcome Crystal, thanks for joining! Good to see u! #IVchatIVchat@IVchat thanks, have kept missing it for past 6 months or so... #ivchatchemosabe@nurseeducator Good to see ya. #IVchatnursingpinsas always, glad to be here #ivchatNursingLink@nurseeducator Hi Teresa, thanks for joining! Welcome! #IVchatIVchat@nurseeducator Hi Teresa, good to see u tonite. #IVchatInfusionNurse@nursingpins Hey Vernon, howdy! #IVchatInfusionNurseYay, so happy to see a lot of our twitter colleagues on tonite. Thank you for joining. First topic coming up next #IVchatIVchat@nursingpins good to see you too! #ivchatNurseEducator@InfusionNurse Happy to be here! Hopefully a delayed visit! #ivchatNurseEducatorTopics will be numbered, pls, prepend w/ topic # when replying #IVchatIVchatT1 - Use of otoscope for finding veins? Ur thoughts? any experience? #IVchatIVchatT1 - honestly, I have not used an otoscope to help find veins...not sure how to use it. #IVchatInfusionNurseT1 Have never used an otoscope - may need to? #IVchatnursingpinsT1 never done it...but can't see y it couldn't work... tend to send our diff accesses for u/s guided cannulae #ivchatchemosabeT1 - of course, its not an approved use for an otoscope. #IVchatInfusionNurseRT @IVchat: Welcome everyone to IVchat! Let's begin with intros, tell us about urselves in <140! #IVchat "interesting chat to checkout"ctsinclairT1 but for that matter, don't most nurses carry a led torch/flashlight these days? #ivchatchemosabeT1 - its interesting but found this article on other uses of otoscope..http://bit.ly/gTTP3i #IVchatIVchatT1 Never used one either for finding veins either! Thinking light might help #ivchatNurseEducatorNurses: going on right now is #IVchat. Check it out. #RNchatRNchatYes, not for finding veins. RT @InfusionNurse: T1 - of course, its not an approved use for an otoscope. #IVchatIVchatlight not enough to illuminate? RT @chemosabe: T1 but for that matter, dont most nurses carry a led torch/flashlight these days? #IVchatInfusionNurseNurses: there's a chat just for you. starts NOW. find it at #ivchatinfoploymentT1 The beam of otoscope light illuminate the tissues of the arms of young infantsfacilitate the location of veins, #IVchatIVchatT1 (cont) appear as dark lines accessible for venipuncture...accdg to the article.. #IVchatIVchatRT @IVchat: T1 The beam of otoscope light illuminate the tissues of the arms of young infantsfacilitate the location of veins, #IVchatInfusionNurse@InfusionNurse probably not...just trying to be creative, besides, don't know that I have an otoscope on my unit...or good batts #ivchatchemosabe@IVchat T1 The beam of otoscope light illuminate the tissues of the arms of young infant ... only useful in infants then maybe... #ivchatchemosabeYes, accdg to that article RT @nurseeducator: T1 Never used one either for finding veins either! Thinking light might help #IVchatIVchatRT @IVchat: T1 - its interesting but found this article on other uses of otoscope..http://bit.ly/gTTP3i #IVchatIVchat@chemosabe perhaps, accdg to that article. I deal w/ adults mainly #IVchatInfusionNurse@InfusionNurse perhaps, accdg to that article. I deal w/ adults mainly ... likewise #ivchatchemosabeT1 I did use a foot operated X-ray viewing light once-same thing I guess. :) Will try it next time I'm grasping for straws-otoscope #IVchatnursingpinsT1 I'm concerned off label use of otoscope here when there r approved devices to find veins..any1 use those? #IVchatInfusionNurseT1 paeds and infs tend to have a more translucent tissue that would be more suited to use of light for venous outlining... #ivchatchemosabe@nursingpins to light up the veins...yes, maybe.. #IVchatIVchat@InfusionNurse bard in Oz promote or sell small uss devices #ivchatchemosabegood point! T @chemosabe: T1 paeds and infs tend more translucent tissue that would be more suited 2 use of light 4 venous outlining #IVchatIVchatT1 - have not seen one of those foot operated lights in years - will have to settle for the otoscope. #IVchatnursingpins@chemosabe Is that used to find veins for PICC insertion or peripheral IV insertion? #IVchatInfusionNursePlan B otoscope RT @nursingpins: T1 - have not seen 1 of those foot operated lights in years - will have to settle for the otoscope. #IVchatIVchat@InfusionNurse promoted for PICC and Midline insertion, but do not see y would not be suitable for exp practitioner with PIVC #ivchatchemosabeT1 - Was going to ask - any new tips for PICC lines that flush w/o resistance but will not draw - many more PICC lines used now. #IVchatnursingpins@nursingpins as in no bld return? #IVchatInfusionNurse@chemosabe many US device r not for PIV insertions, there r devices avail here in the Stated 4 PIV use. #IVchatIVchatT1 Yes - many nurses drawing from them now - seems like a lg # quit drawing? #IVchatnursingpins@IVchat sure there are down here too... cost is the issue... #ivchatchemosabe@nursingpins ..then there's a prob w/ the line, mayb fibrin buidlup..might need to use cathflo.. #IVchatInfusionNurse@chemosabe So true, cost of those devices is a concern, perhaps hard to justify for PIV only #IVchatIVchatT1 some hosps have a policy for tpa (PICC) lines - some don't - nurses are taking a risk w/o policy. #IVchatnursingpins@IVchat precisely y have not invested in any to this point in time... particularly wen our med imaging depart will do them 4 us... #ivchatchemosabe@nursingpins...all PICC/central lines shld have a blood return..#ivchatVascularAccess@nursingpins ..need an order for cathflo - it is approved for clearing lines (not tpa) #IVchatInfusionNurseT2 - many PICC lines will not draw blood? still flush w/o resistance? #IVchatnursingpinsRT @VascularAccess: @nursingpins...all PICC/central lines shld have a blood return..#ivchat #IVchatIVchatNext topic coming up... #IVchatIVchat@chemosabe nice that u have that service, many hosp here dont so nurses have to be creative #IVchatIVchatwe tend to go venogram or portogram to see what patency or alteration of flow is if no flashing back or bleeding. #ivchatchemosabe@IVchat yes we are fortunate, but still a pain in a$$.. #ivchatchemosabeRT @nursingpins: T2 - many PICC lines will not draw blood? still flush w/o resistance? #IVchatIVchatnice RT @chemosabe: we tend to go venogram or portogram to see what patency or alteration of flow if no flashing back or bleeding. #IVchatInfusionNursemayb revisit how it is cared 4..RT @nursingpins: T2 - many PICC lines will not draw blood? still flush w/o resistance? #IVchatInfusionNurseT3 - would honestly say that you follow the 15 sec rule for scrubbing hubs w/ alcohol? #IVchatIVchatT3 conjecture down here that due to this issue better off not to scrub hubs at all!?!? #ivchatchemosabeT3 - I must admit I do... :) #IVchatInfusionNurseT2 thanx for this topic Vernon, apart from Cathflo, which need to clarify for ozzie, was there any other tips? #ivchatchemosabe15 seconds is rule for handwashing... with alcohol, isn't only until dry? #IVchatswan5675T3 Cent line care is not consistent here - one of the many things we need standard policy for. #IVchatnursingpinsReally no scrubbing just accessRT @chemosabe: T3 conjecture down here that due to this issue better off not to scrub hubs at all!?!? #IVchatIVchatT3 personally, wait for glisten to go off hub/injection port/bung whatever we call it #ivchatchemosabeSo sorry! family over for a quick visit #ivchatNurseEducator@IVchat not so much with piccs and ports but with IMI injections and PIVC bungs yes... not in policy anywhere though...? #ivchatchemosabeRT @chemosabe: T3 personally, wait for glisten to go off hub/injection port/bung whatever we call it #IVchatInfusionNurseDefinitelyRT @nursingpins: T3 Cent line care is not consistent here - one of the many things we need standard policy for. #IVchatInfusionNurseAlso 4 hubs RT @swan5675: 15 seconds is rule for handwashing... with alcohol, isnt only until dry? #IVchatInfusionNurse@nurseeducator no prob, welcome back! #IVchatInfusionNurseT3 - a concern for CR BSI.. #IVchatIVchatWe have IV team at our hospital to ensure consistency with central line care.On chemo floor we do our own. #IVChatJoyceHarrellRN@nursingpins ,,there are standards of practice you can use as reference. eg INS standard of practice for infusion nursing #IVchatIVchatT3 - @chemosabe, so if not scrubbing at all, what's ur infection rate? #IVchatInfusionNurseRT @joyceharrellrn: We have IV team at our hospital to ensure consistency with central line care.On chemo floor we do our own. #IVchatIVchatWe have to obtain dye study before using if no blood return. #IVChatJoyceHarrellRN@InfusionNurse ahh the beauty/danger of having an inf control depart that does not monitor IV site rates or BSI rates??? #ivchatchemosabeGood policy to have, wish every1 will do that RT @joyceharrellrn: We have to obtain dye study before using if no blood return. #IVchatInfusionNurse@joyceharrellrn do u follow same procedure on CL as the IV team? #IVchatInfusionNurse@IVchat Thanks - So many of NO procedures stem from the (Watch one, Do one, Show one) from The old Charity Hosp. #IVchatnursingpinsLOL..RT @chemosabe: ahh the beauty/danger of having an inf control depart that does not monitor IV site rates or BSI rates??? #IVchatIVchatRT @InfusionNurse: Good policy to have, wish every1 will do that RT: We have to obtain dye study before using if no blood return. #IVChatJoyceHarrellRN@InfusionNurse @joyceharrellrn one hosp in Brisbane has nurse led PICC team, and have done since the early nineties... #ivchatchemosabeRT @InfusionNurse: @joyceharrellrn do u follow same procedure on CL as the IV team? Yes,using the hosp. policies. #IVChatJoyceHarrellRNRT @chemosabe: @InfusionNurse @joyceharrellrn one hosp in Brisbane has nurse led PICC team, and have done since the early nineties. #IVChatJoyceHarrellRNI'm an oncology nurse, so we mostly deal with Picc's and Port's on our unit. #IVChatJoyceHarrellRNImpressive RT @chemosabe:@joyceharrellrn one hosp in Brisbane has nurse led PICC team, and have done since the early nineties... #IVchatInfusionNurseT3 - back to hub scrubbing, do u think new devices like alcohol impregnated connectors (swabcaps) will help with CRBSI prevention? #IVchatIVchatanother uses the Oncology Nurses to do all PICC and Port care... #ivchatchemosabe@nursingpins good time to show them the "evidence" or standards!! LOL #IVchatIVchatT3 - back to hub scrubbing, do u think new devices like alcohol impregnated connectors (swabcaps) will help with CRBSI prevention? #IVChatJoyceHarrellRNRT @chemosabe: another uses the Oncology Nurses to do all PICC and Port care... Good Idea... #IVChatJoyceHarrellRNYes ONS just released the Access Device Guidelines RT @chemosabe: another uses the Oncology Nurses to do all PICC and Port care... #IVchatInfusionNurseRT @InfusionNurse: Yes ONS just released the Access Device Guidelines RT @chemosabe: another uses the Oncology Nurses #IVchatIVchat@IVchat You are right - #IVchatnursingpinsT3 best stick to the standards and infection control policies... are injection sites/hubs/bungs routinely changed up there? #ivchatchemosabeI came in a little late. We don't use the impregnated connectors. #IVChatJoyceHarrellRNT3 - here's info on swabcaps http://bit.ly/eoEbKT (not an endorsement) there r others #IVchatIVchat@chemosabe. We have policies on when to change needles, drsg changes, hubs. #IVChatJoyceHarrellRN@chemosabe Changed q 7 days here (with bio-patch) but again not standard. #IVchatnursingpinsYes RT @chemosabe: T3 are injection sites/hubs/bungs routinely changed up there? #IVchatInfusionNurseRT @IVchat: T3 - heres info on swabcaps http://bit.ly/eoEbKT (not an endorsement) there r others (Thank you) #IVChatJoyceHarrellRNRT @IVchat: T3 - heres info on swabcaps http://bit.ly/eoEbKT (not an endorsement) there r others #IVchatInfusionNurseWe change port needles q 6 days, caps after every blood draw, or every 3 days if no blood draw. #IVChatJoyceHarrellRNRT @joyceharrellrn: We change port needles q 6 days, caps after every blood draw, or every 3 days if no blood draw. #IVchatInfusionNurse@joyceharrellrn 6 days not 7days? just curious most r 7 days #IVchatIVchatDont u down there? RT @chemosabe: T3 are injection sites/hubs/bungs routinely changed up there? #IVchatIVchatT3 just referred to loc pol... swabbed with alco and allowed to dry... bungs changed per manufacturers guidelines... cop out ... #ivchatchemosabeWe do it 6 days. I think it was originally for keeping a flow. Tubing change on CL were every 3 days.So, everything is in sync #IVChatJoyceHarrellRNRT @chemosabe: T3 just referred to loc pol... swabbed w/ alco, allowed to dry, bungs changed per manufacturers guidelines, cop out #IVchatInfusionNurseHey there @nursingpins...Fun topic. #IVChatJoyceHarrellRN@IVchat Dont u down there? anecdotally some hosps in bris not changing bungs routinely on PICCs #ivchatchemosabeT3 @joyceharrellrn like the idea of 6 days for sync but system-wide we are 7 days #ivchatNurseEducatorWow, we're almost at an hour, wanted to wrap up a bit early to allow time to switch to #MDchat. Any parting thoughts? #IVchatIVchatYes, do u insert PIVs bevel up or bevel down...LOL..just curious! #IVchatInfusionNurse@joyceharrellrn Hi - listening - :) and learning. #IVchatnursingpinsnothing more to add, but, thanks, exactly sort of discussions i was anticipating, thanks all #ivchatchemosabe@InfusionNurse bev up of course... doesn't everyone...? #ivchatchemosabe@nurseeducator It makes it flow nice. Day three tubing and caps change, day six, tubing, caps, needle.drsg, (unless blood draws) #IVChatJoyceHarrellRNit is changed regularly per policy RT@chemosabe: Dont u down there?anecdotally some hosps in bris not changing bungs routinely PICCs #IVchatInfusionNurseRT @nursingpins: @joyceharrellrn Hi - listening - :) and learning. Always fun to learn. #IVChatJoyceHarrellRN@InfusionNurse a few down ugh ... so traumatic ... surprised they are successful? #ivchatchemosabeRT @InfusionNurse: Mostly said up, a few down RT @chemosabe: @InfusionNurse bev up of course.. (Bev up for me always for any needle) #IVChatJoyceHarrellRNIt's a wrap, thank you so much everyone for joining tonight. It has been fun and interesting!! Good nite all!! #IVchatIVchatHad never heard of bevel down? thought I missed something.- #IVchatnursingpinsgood morning all. good sleep #ivchatchemosabeThanks Cora and all present. #IVchatnursingpinsThanks, sorry I got on late. #IVChatJoyceHarrellRNYes, a few said down RT @nursingpins: Had never heard of bevel down? thought I missed something.- #IVchatInfusionNurseGood night! Missed most of a good chat! #ivchatNurseEducatorThanks Glenn RT @chemosabe: good morning all. good sleep #IVchatIVchatNext IV chat will be Dec. 8 Wed 8PM! #IVchatIVchatRT @chemosabe: good morning all.good sleep(my days and nights are always messed up.Onc nurse by night, wellness coach by day..:) ) #IVChatJoyceHarrellRNWe missed u too, but summary will be up in a few RT @nurseeducator: Good night! Missed most of a good chat! #IVchatIVchatThanks everyone for joining, this was so fun!! Love that Glen could join us from down under. Till next chat. #IVchatInfusionNursewill put it in my diary... off to physical meeting now! #ivchatchemosabe@joyceharrellrn @chemosabe @nursingpins @nurseeducator thanks have a wonderful week. Happy Thanksgiving to those in the states. #IVchatInfusionNurse@InfusionNurse@chemosabe @nursingpins @nurseeducator thanks have a wonderful week.Happy Thanksgiving to those in the states. #IVChatJoyceHarrellRNIV flushes with saline>IV flushes with heparin. #ebp #IVchat #whatILearnedMarcia_Lynn23RT @joyceharrellrn: @InfusionNurse@chemosabe @nursingpins thanks have a wonderful week.Happy Thanksgiving to those in the states. #ivchatNurseEducatorIf u all have time, go over to #MDchat now in progress #IVchatIVchatsee my blog http://is.gd/hFPBs RT @nursingpins: Had never heard of bevel down? thought I missed something.- #IVchatInfusionNurseSaline preferred RT @Marcia_Lynn23: IV flushes with saline>IV flushes with heparin. #ebp #IVchat #whatILearned #IVchatInfusionNurseThanks, have a great day!! RT @chemosabe: will put it in my diary... off to physical meeting now! #IVchatIVchatRT @IVchat: Next IV chat will be Dec. 8 Wed 8PM! #IVchatIVchatSad I missed #IVchat today! Hopefully I'll catch the next one.jennparsonage@swan5675 ..oops, sorry just saw ur tweet, use tweetchat.com next time and enter #IVchat. www.ivchat.org has the summaries of past chats.IVchat@nursinglink - I know its past 5 ur time but thanks for joining #IVchat.IVchat@IVchat just saw this post. I apparently missed it. #IVchatbthenextstepjust testing........ #IVchatswan5675kewl! I know how to do this, now. Thanks! Am looking forward to the next chat (When is it?) #IVchatswan5675I see next chat is December 8 (My birthday...easy to remember.) It is at 8PM....but, in what time zone? I live in Indiana. #IVchatswan5675<br />