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IVchat 02022011

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IVchat 02022011

  1. 1. #IVchat Healthcare Hashtag Twitter Transcript From: Wed Feb 02 17:00:00 PST 2011 To: Wed Feb 02 18:10:00 PST 2011 Learn more about #IVchat at The Healthcare Hashtag Project IVchat It's IV chat time...good evening and welcome to another edition of IV chat! Let's start w/ introductions.... #IVchat Wed Feb 2 17:00:02 PST 2011 InfusionNurse Hi all. I'm Cora, infusion nurse and moderator of IVchat..welcome everyone.. #IVchat Wed Feb 2 17:00:35 PST 2011 joyceharrellrn RT @IVchat: Its IV chat time...good evening and welcome to another edition of IV chat! Lets start w/ introductions.... #IVchat Wed Feb 2 17:01:22 PST 2011 VascularAccess Hey @IVchat ..Michelle here....hope y'all r staying warm #IVchat Wed Feb 2 17:02:06 PST 2011 joyceharrellrn I'm Joyce Harrell. Oncology Nurse, and Wellness Coach Educator. Hi everyone! #IVchat Wed Feb 2 17:02:26 PST 2011 joyceharrellrn @VascularAccess @IVchat Hi Michelle! #IVchat Wed Feb 2 17:02:52 PST 2011 IVchat @VascularAccess Hi and welcome!! #IVchat Wed Feb 2 17:02:55 PST 2011 chemosabe hey y'all glen downunda 1100hrs 3/02 #ivchat Wed Feb 2 17:03:03 PST 2011 joyceharrellrn @chemosabe Hey chemosabe!!! #IVchat Wed Feb 2 17:03:31 PST 2011 IVchat Hi Joyce and Michelle!! RT @joyceharrellrn: @VascularAccess Hi Michelle! #IVchat Wed Feb 2 17:03:32 PST 2011 IVchat @chemosabe Hi Glen, welcome - hope ur weather is better!! #IVchat Wed Feb 2 17:03:55 PST 2011
  2. 2. joyceharrellrn @chemosabe So how is the weather, Glen from downunda? #IVchat Wed Feb 2 17:04:14 PST 2011 InfusionNurse Welcome to all, regulars and lurkers...glad to see you again!! #IVchat Wed Feb 2 17:04:25 PST 2011 IVchat First topic coming up...pls use T1. T2 etc..b4 ur replies... #IVchat Wed Feb 2 17:05:43 PST 2011 InfusionNurse @joyceharrellrn Hi JOyce, how are you? #IVchat Wed Feb 2 17:06:02 PST 2011 joyceharrellrn @InfusionNurse I'm good. Doing a little studying. :) #IVchat Wed Feb 2 17:06:39 PST 2011 chemosabe hey back at you @joyceharrellrn #ivchat, wet but not windy this far south. humidity 90% T 31C Wed Feb 2 17:07:06 PST 2011 joyceharrellrn @InfusionNurse Are you snowed in? #IVchat Wed Feb 2 17:07:13 PST 2011 InfusionNurse @joyceharrellrn great...looks like as cozy group tonight... #IVchat Wed Feb 2 17:07:20 PST 2011 IVchat T1 - do u routinely offer pts. or use local anesth prior to IV sticks or port access to decrease pain? #IVchat Wed Feb 2 17:07:21 PST 2011 chemosabe snow front up there looks pretty impressive too #ivchat Wed Feb 2 17:07:35 PST 2011 joyceharrellrn RT @IVchat: T1 - do u routinely offer pts. or use local anesth prior to IV sticks or port access to decrease pain? #IVchat Wed Feb 2 17:07:42 PST 2011 InfusionNurse yup, RT @joyceharrellrn: @InfusionNurse Are you snowed in? #IVchat Wed Feb 2 17:08:00 PST 2011 InfusionNurse RT @IVchat: T1 - do u routinely offer pts. or use local anesth prior to IV sticks or port access to decrease pain? #IVchat Wed Feb 2 17:08:26 PST 2011 joyceharrellrn T1 - it is not in our policy to use it where I am now. I used to. When I ran cancer center, used Emla cream, or the freeze spray #IVchat Wed Feb 2 17:09:25 PST 2011 chemosabe T1 no do not routinely offer, 1 of my staff does, and then pts expect it! #ivchat Wed Feb 2 17:09:29 PST 2011
  3. 3. InfusionNurse T1 - pts w/ ports like the lmx cream...helps with needle access #IVchat Wed Feb 2 17:09:36 PST 2011 joyceharrellrn T1- Since I can't use now, before port access, I tell them to take a deep breath and hold it. It seems to help. #IVchat Wed Feb 2 17:10:23 PST 2011 chemosabe T1 had 1 pt that used 2 want sc lignocaine prior to Port stick. #ivchat Wed Feb 2 17:10:34 PST 2011 InfusionNurse @joyceharrellrn ..T1- isnt it a TJC mandate to reduce pain prior to procedures like IV sticks? #IVchat Wed Feb 2 17:10:42 PST 2011 InfusionNurse do the pts like ?RT @chemosabe: T1 no do not routinely offer, 1 of my staff does, and then pts expect it! #IVchat Wed Feb 2 17:11:00 PST 2011 chemosabe T1 do offer emla to port pts if they are woosy enough to desire it, particularly tho, new ports #ivchat Wed Feb 2 17:11:18 PST 2011 IVchat RT @joyceharrellrn: T1- Since I cant use now, before port access, I tell them to take a deep breath and hold it. It seems to help. #IVchat Wed Feb 2 17:11:30 PST 2011 joyceharrellrn T1. Hummm. This would make a good research project at the hospital where I am.I will pass it on to them to investigate. #IVchat Wed Feb 2 17:11:57 PST 2011 InfusionNurse @chemosabe no Joint commission mandate to reduce pain, so not routinely offered? #IVchat Wed Feb 2 17:12:03 PST 2011 InfusionNurse @joyceharrellrn . u mean emla? now they have LMX cream... #IVchat Wed Feb 2 17:12:35 PST 2011 IVchat RT @InfusionNurse: @joyceharrellrn ..T1- isnt it a TJC mandate to reduce pain prior to procedures like IV sticks? #IVchat Wed Feb 2 17:13:01 PST 2011 chemosabe @InfusionNurse most of my staff do no offer local prior pivc, creates issues 4 them/us when pt expects it. Needle phobia, ? practice #ivchat Wed Feb 2 17:13:16 PST 2011 InfusionNurse T1 - do u use lidocaine or bacteriostatic NS to numb b4 iv sticks? #IVchat Wed Feb 2 17:13:41 PST 2011 chemosabe @InfusionNurse r: mandate - speakin foriegn language there! #ivchat Wed Feb 2 17:14:00 PST 2011
  4. 4. joyceharrellrn T1 - We sometimes gave them RX for emla to use before they came to clinic. #IVchat Wed Feb 2 17:14:12 PST 2011 chemosabe T1 argue that local injection is as painful if not more so than PIVC cannula #ivchat Wed Feb 2 17:14:45 PST 2011 joyceharrellrn T1 - What's that freeze spray, starts with a F.. It's been awhile since I used it. #IVchat Wed Feb 2 17:14:53 PST 2011 InfusionNurse @chemosabe There is a mandate from the Joint commision here - they accredit hosps.. #IVchat Wed Feb 2 17:15:06 PST 2011 joyceharrellrn T1 - how does bacteriostatic NS help to numb? #IVchat Wed Feb 2 17:15:33 PST 2011 chemosabe T1 local lotions MAY distort palpation and vision of veins w/ localised blanching & relaxation of venous musculature #ivchat Wed Feb 2 17:15:56 PST 2011 InfusionNurse true but there r topical ones RT @chemosabe: T1 argue that local injection is as painful if not more so than PIVC cannula #IVchat Wed Feb 2 17:15:59 PST 2011 joyceharrellrn @chemosabe Aren't you lucky not having to deal with TJC... :) #IVchat Wed Feb 2 17:16:24 PST 2011 VascularAccess T1 - prob w/ topical is the wait time...#IVchat Wed Feb 2 17:16:30 PST 2011 joyceharrellrn @VascularAccess We had them apply to port before coming to clinic... #IVchat Wed Feb 2 17:16:58 PST 2011 IVchat RT @VascularAccess: T1 - prob w/ topical is the wait time...#IVchat #IVchat Wed Feb 2 17:16:59 PST 2011 IVchat RT @chemosabe: T1 local lotions MAY distort palpation and vision of veins w/ localised blanching & relaxation of venous musculature #IVchat Wed Feb 2 17:17:03 PST 2011 InfusionNurse @chemosabe is it not a concern if inserting a large bore cannula = painful #IVchat Wed Feb 2 17:17:45 PST 2011 IVchat RT @joyceharrellrn: @VascularAccess We had them apply to port before coming to clinic... #IVchat Wed Feb 2 17:18:02 PST 2011 chemosabe T1 have seen study that suggests wait time on local lotion could be placebo & therefore 5 mins may be sufficient #ivchat Wed Feb 2 17:18:44 PST 2011
  5. 5. VascularAccess T1 - has any1 use NS to numb b4 sticking iV needle? its works for me...#IVChat Wed Feb 2 17:18:53 PST 2011 InfusionNurse Yes I have..it does work!! RT @VascularAccess: T1 - has any1 use NS to numb b4 sticking iV needle? its works for me...#IVChat #IVchat Wed Feb 2 17:19:40 PST 2011 chemosabe @InfusionNurse large bore ( = >20g ) only time I routinely use local Yes #ivchat Wed Feb 2 17:19:53 PST 2011 joyceharrellrn @VascularAccess T1- how does NS work to numb? #IVchat Wed Feb 2 17:19:54 PST 2011 InfusionNurse RT @chemosabe: T1 have seen study that suggests wait time on local lotion could be placebo & therefore 5 mins may be sufficient #IVchat Wed Feb 2 17:20:07 PST 2011 VascularAccess @JoyceHarrellRN ..the preservative - benzyl alcohol serves as the anesth agent...#IVchat Wed Feb 2 17:20:50 PST 2011 InfusionNurse Whew, good to hear LOL..RT @chemosabe: @InfusionNurse large bore ( = >20g ) only time I routinely use local Yes #IVchat Wed Feb 2 17:21:36 PST 2011 chemosabe Health care down here is accredited but have no mandate on minimising or removing pain #ivchat Wed Feb 2 17:22:18 PST 2011 IVchat T1 any1 use lidocaine to numb site? #IVchat Wed Feb 2 17:22:22 PST 2011 joyceharrellrn @VascularAccess Thanks! I didn't realize the NS had a preservative like that. #IVchat Wed Feb 2 17:22:44 PST 2011 chemosabe T1 pisses me off though when tattooed and peirced patients expect local! not ethical of me I know but come on #ivchat Wed Feb 2 17:23:20 PST 2011 TriniRN Thx 4 the info!RT @joyceharrellrn @VascularAccess Thanks! I didn't realize the NS had a preservative like that. #IVchat Wed Feb 2 17:23:56 PST 2011 InfusionNurse @chemosabe there is here...prevention and reduction of unnecessary pain associated w/ procedures #IVchat Wed Feb 2 17:23:59 PST 2011 chemosabe @IVchat when we do use local it is routinely subcut lignocaine for PIVC and local lotion for ports (EMLA) #ivchat Wed Feb 2 17:24:21 PST 2011
  6. 6. IVchat LOL RT @chemosabe: T1 pisses me off though when tattooed and peirced patients expect local! not ethical of me I know but come on #IVchat Wed Feb 2 17:24:26 PST 2011 InfusionNurse Yes, also skin stretch RT @VascularAccess: @JoyceHarrellRN ..the preservative - benzyl alcohol serves as the anesth agent...#IVchat #IVchat Wed Feb 2 17:25:13 PST 2011 momof2chocdivas #IVchat Hey we are learning all about it in#nursingschool. Any advice is welcomed! Wed Feb 2 17:25:27 PST 2011 joyceharrellrn @chemosabe T1 I know.I had one the other day.Tatoos all over.When she said she was scared of needles,I said"you've got to be kidding #IVchat Wed Feb 2 17:25:47 PST 2011 IVchat As you inject intradermally? RT @InfusionNurse: Yes, also skin stretch ..the preservative - benzyl alcohol serves as anesth agent #IVchat Wed Feb 2 17:26:09 PST 2011 chemosabe @IVchat Does that mean u have to use local lotion b4 s/c and IM injections also? Don't see diff with skilled cannulator #ivchat Wed Feb 2 17:26:12 PST 2011 IVchat Great! Welcome! RT @momof2chocdivas: #IVchat Hey we are learning all about it in #nursingschool. Any advice is welcomed! #IVchat Wed Feb 2 17:26:24 PST 2011 joyceharrellrn @chemosabe My patients tell me my shots don't hurt. After 20 years, I would hope I have mastered that one. #IVchat Wed Feb 2 17:27:03 PST 2011 InfusionNurse @chemosabe only w/ large bore needles for IV sticks... #IVchat Wed Feb 2 17:27:13 PST 2011 InfusionNurse RT @joyceharrellrn: @chemosabe My patients tell me my shots dont hurt. After 20 years, I would hope I have mastered that one. #IVchat Wed Feb 2 17:27:34 PST 2011 InfusionNurse @momof2chocdivas ..chime in anytime.. #IVchat Wed Feb 2 17:27:55 PST 2011 joyceharrellrn @InfusionNurse @chemosabe I try to use only 22's and 20's. I NEVER use anything bigger. #IVchat Wed Feb 2 17:27:58 PST 2011 IVchat T2 coming up next... #IVchat Wed Feb 2 17:28:02 PST 2011
  7. 7. chemosabe @JoyceHarrellRN for sure - get the pts that tell u they prefer the #nurses to doctors 2 #ivchat Wed Feb 2 17:28:18 PST 2011 joyceharrellrn RT @chemosabe: @JoyceHarrellRN for sure - get the pts that tell u they prefer the #nurses to doctors 2 #IVchat Wed Feb 2 17:28:50 PST 2011 InfusionNurse There are several studies on effectiveness of local anesth prior to IVsticks - both on lidocaine and NS... #IVchat Wed Feb 2 17:28:59 PST 2011 chemosabe @JoyceHarrellRN agree only times I had to go bigger than 20G routinely was when doing venesections #ivchat Wed Feb 2 17:29:32 PST 2011 InfusionNurse 18g used in surgery sometimes...RT @chemosabe: @JoyceHarrellRN #IVchat Wed Feb 2 17:30:29 PST 2011 IVchat T2 - Where's your IV site - how do you or do u document IV starts, failed attempts....etc?? #IVchat Wed Feb 2 17:30:30 PST 2011 joyceharrellrn @chemosabe Yes, I understand that one. The lab does that. You are talking about pulling off venous blood, right? #IVchat Wed Feb 2 17:30:42 PST 2011 momof2chocdivas #nursingschool #IVchat going on right now! Reading the tweets very informative! Wed Feb 2 17:30:47 PST 2011 VascularAccess T2 - yes ma'am!! #IVchat who doesn't? Wed Feb 2 17:31:37 PST 2011 joyceharrellrn T2- since we are computer, the form actually has a place for all that information when re start or restart. #IVchat Wed Feb 2 17:31:41 PST 2011 joyceharrellrn RT @IVchat: T2 - Wheres your IV site - how do you or do u document IV starts, failed attempts....etc?? #IVchat Wed Feb 2 17:31:57 PST 2011 chemosabe T2 created stamp for chart that identifies size, site, no. of attempts, time date and operator #ivchat Wed Feb 2 17:32:16 PST 2011 InfusionNurse Is it a diagram or text? RT @joyceharrellrn: T2- since we are computer, the form actually all that info when re start or restart. #IVchat Wed Feb 2 17:32:32 PST 2011
  8. 8. holisticnurses Agreed!RT @momof2chocdivas: #nursingschool #IVchat going on right now! Reading the tweets very informative! Wed Feb 2 17:32:32 PST 2011 Christinajoi RT @momof2chocdivas #nursingschool #IVchat going on right now! Reading the tweets very informative!<<I'll be reading them as well Wed Feb 2 17:32:54 PST 2011 joyceharrellrn @InfusionNurse Its actually a text. #IVchat Wed Feb 2 17:33:06 PST 2011 IVchat RT @chemosabe: T2 created stamp for chart that identifies size, site, no. of attempts, time date and operator #IVchat Wed Feb 2 17:33:06 PST 2011 chemosabe @JoyceHarrellRN yeah therapeutic venesection for PRV and Haemochromatosis #ivchat Wed Feb 2 17:33:18 PST 2011 InfusionNurse great - site ie anatomic name? RT @chemosabe: T2 created stamp chart that identifies size, site, no. of attempts, time date operator #IVchat Wed Feb 2 17:33:35 PST 2011 InfusionNurse therapeutic phlebotomy? RT @chemosabe: @JoyceHarrellRN yeah therapeutic venesection for PRV and Haemochromatosis #IVchat Wed Feb 2 17:34:09 PST 2011 joyceharrellrn @chemosabe Right. Our lab did it, but came to our department to do it. They didn't use anesth. either. #IVchat Wed Feb 2 17:34:18 PST 2011 IVchat @Christinajoi @momof2chocdivas @holisticnurses - welcome to IVchat! Join anytime #IVchat Wed Feb 2 17:34:54 PST 2011 joyceharrellrn @InfusionNurse Yes, therapeutic phlebotomy is what we call it here in the states. #IVchat Wed Feb 2 17:34:56 PST 2011 chemosabe @InfusionNurse site meant 2 refer 2 the actual vein & location, if u know ur anatomoy well enough. most just put back of hand, etc #ivchat Wed Feb 2 17:35:22 PST 2011 chemosabe @InfusionNurse yeah same deal diff country lol #ivchat Wed Feb 2 17:35:52 PST 2011 VascularAccess T2 - does any nurse here say they really use the anatomical description..ie. cephalic or just right wrist/hand? #IVchat Wed Feb 2 17:36:02 PST 2011 joyceharrellrn @chemosabe LOL #IVchat Wed Feb 2 17:36:14 PST 2011
  9. 9. IVchat RT @VascularAccess: T2 - does any nurse here say they really use the anatomical description..ie. cephalic or just right wrist/hand? #IVchat Wed Feb 2 17:36:46 PST 2011 chemosabe @VascularAccess yeah ME most times! #ivchat Wed Feb 2 17:36:47 PST 2011 joyceharrellrn @VascularAccess T2- I use general description. #IVchat Wed Feb 2 17:36:58 PST 2011 chemosabe just noticed i can''t spell A-N-A-T-O-M-Y tho #ivchat Wed Feb 2 17:37:39 PST 2011 InfusionNurse T2 - anyone using a anatomical diagram where they just X = mark the spot? #IVchat Wed Feb 2 17:37:42 PST 2011 chemosabe @InfusionNurse negative #ivchat Wed Feb 2 17:38:44 PST 2011 IVchat @chemosabe ..aside from TJC, there are standards of practice for infusion nursing here..is there one down under? #IVchat Wed Feb 2 17:38:55 PST 2011 onlinenursing I made it but I am late! #IVchat Wed Feb 2 17:38:58 PST 2011 IVchat @onlinenursing Welcome Terri!! better late than never... #IVchat Wed Feb 2 17:39:28 PST 2011 holisticnurses @onlinenursing Me too! Although mostly lurking, all! Hello. #IVChat Wed Feb 2 17:39:42 PST 2011 swan5675 me, too! Was out shoveling..... #IVchat Wed Feb 2 17:39:43 PST 2011 InfusionNurse INS standard does state what elements to document on IV starts...new 2011 standards r out now.. #IVchat Wed Feb 2 17:40:05 PST 2011 holisticnurses Can you resend T2 please? Thx, Cora. #IVChat Wed Feb 2 17:40:09 PST 2011 IVchat @swan5675 @holisticnurses ...welcome ladies! #IVchat Wed Feb 2 17:40:34 PST 2011 onlinenursing Just want to say re: t1 - that we teach students to do saline bleb now prior to IV stick, greatly reduces pain #IVchat Wed Feb 2 17:40:46 PST 2011
  10. 10. IVchat RT @IVchat: T2 - Wheres your IV site - how do you or do u document IV starts, failed attempts....etc?? #IVchat Wed Feb 2 17:40:53 PST 2011 chemosabe @IVchat No not particularly - still a back water down here. haven't had to fear legal crap down here like up there tho! #ivchat Wed Feb 2 17:40:54 PST 2011 swan5675 T2 We use anatomical description: "right hand, third metacarpal vein"... #IVchat Wed Feb 2 17:41:29 PST 2011 IVchat RT @onlinenursing: Just want to say re: t1 - that we teach students to do saline bleb now prior to IV stick, greatly reduces pain #IVchat Wed Feb 2 17:41:43 PST 2011 InfusionNurse @chemosabe LOL, would love to send u a copy... #IVchat Wed Feb 2 17:41:46 PST 2011 chemosabe hey all the l8 snow shovelling arrivals #ivchat Wed Feb 2 17:41:57 PST 2011 swan5675 ;) #IVchat Wed Feb 2 17:42:32 PST 2011 InfusionNurse YAY!!RT @swan5675: T2 We use anatomical description: "right hand, third metacarpal vein"... #IVchat Wed Feb 2 17:42:33 PST 2011 onlinenursing @swan5675 how much did you get? We got between 12-16 inches. My arms are tired :) #IVchat Re: Snow shoveling Wed Feb 2 17:42:35 PST 2011 IVchat LOL...they were exercising...RT @chemosabe: hey all the l8 snow shovelling arrivals #IVchat Wed Feb 2 17:42:51 PST 2011 chemosabe @swan5675 wow THAT is even more specific than i put, don't tend to count the vein #ivchat Wed Feb 2 17:42:56 PST 2011 holisticnurses @chemosabe @swan5675 I agree. That is precise documentation. Good documentation. T2 #IVChat Wed Feb 2 17:43:44 PST 2011 IVchat T3 - coming up... #IVchat Wed Feb 2 17:43:51 PST 2011 swan5675 @onlinenursing 10 inches, 15 less than expected due to the last half being freezing rain after initial blizzard #IVchat Wed Feb 2 17:43:54 PST 2011
  11. 11. chemosabe @onlinenursing was a man or woman measuring the depth #ivchat Wed Feb 2 17:44:12 PST 2011 InfusionNurse Seriously, there is a standard that outlines what to chart.. #IVchat Wed Feb 2 17:44:25 PST 2011 IVchat LOL...RT @chemosabe: @onlinenursing was a man or woman measuring the depth #IVchat Wed Feb 2 17:44:41 PST 2011 IVchat AMEN!! RT @holisticnurses: @chemosabe @swan5675 I agree. That is precise documentation. Good documentation. T2 #IVchat Wed Feb 2 17:44:55 PST 2011 holisticnurses FYI re: IV insertion. RT @InfusionNurse: Seriously, there is a standard that outlines what to chart.. #IVChat Wed Feb 2 17:44:56 PST 2011 swan5675 @chemosabe Only reason we are so specific is so that ... in case of problems... the exact stick can be analyzed #IVchat Wed Feb 2 17:45:17 PST 2011 IVchat T3 - now do u routinely chart about status of PIV? every hour or every shift or nada?? #IVchat Wed Feb 2 17:45:39 PST 2011 Christinajoi OK! >>RT @IVchat @Christinajoi @momof2chocdivas @holisticnurses - welcome to IVchat! Join anytime #IVchat Wed Feb 2 17:46:12 PST 2011 chemosabe @swan5675 is that the litigation thing again, or just good practice to id and improve care? #ivchat Wed Feb 2 17:46:31 PST 2011 holisticnurses @Christinajoi Hey there! :) #IVChat Wed Feb 2 17:46:41 PST 2011 InfusionNurse good! RT @swan5675: @chemosabe Only reason we are so specific is so that ... in case of problems... the exact stick can be analyzed #IVchat Wed Feb 2 17:46:47 PST 2011 lorryschoenly Just a quick hat tip to the folks on #ivchat tonight. Been off the grid this week. U's guys rock! Wed Feb 2 17:46:58 PST 2011 swan5675 T3 every hour.... however, I highly doubt that is what all are actually doing...... #IVchat Wed Feb 2 17:47:08 PST 2011 IVchat RT @chemosabe: @swan5675 is that the litigation thing again, or just good practice to id and improve care? #IVchat Wed Feb 2 17:47:13 PST 2011
  12. 12. chemosabe man my email notifications are going nuts here, gonna have so much to deal with when we r done #ivchat Wed Feb 2 17:47:16 PST 2011 InfusionNurse @lorryschoenly ..hey girl, miss u... #IVchat Wed Feb 2 17:47:38 PST 2011 IVchat RT @swan5675: T3 every hour.... however, I highly doubt that is what all are actually doing...... #IVchat Wed Feb 2 17:47:57 PST 2011 VascularAccess T3 - observe it freq but chart only every hour...#IVchat Wed Feb 2 17:48:20 PST 2011 chemosabe T3 in ward prac checked 4 hourly and charted ea shift #ivchat Wed Feb 2 17:48:53 PST 2011 holisticnurses @swan5675 Hospital to homecare discharge papers would greatly benefit from PIV site info for that same reason, even if removed. T2 #IVChat Wed Feb 2 17:48:55 PST 2011 IVchat both RT @chemosabe: @swan5675 is that the litigation thing again, or just good practice to id and improve care? #IVchat Wed Feb 2 17:48:58 PST 2011 chemosabe T3 resite date noted in care plan #ivchat Wed Feb 2 17:49:29 PST 2011 IVchat RT @chemosabe: T3 in ward prac checked 4 hourly and charted ea shift #IVchat Wed Feb 2 17:49:33 PST 2011 Christinajoi @InfusionNurse What degree angle is preferred when doing lidocane? I was told 20 degree angle is best.. is this true? #IVChat Wed Feb 2 17:49:57 PST 2011 swan5675 @holisticnurses Absolutely! We do it for all concerned... these patients go everywhere #IVchat Wed Feb 2 17:50:14 PST 2011 InfusionNurse RT @holisticnurses: @swan5675 Hospital to homecare disc papers would greatly benefit fr PIV site info same reasoneven if removed. T2 #IVchat Wed Feb 2 17:50:22 PST 2011 swan5675 RT @IVchat: RT @chemosabe: T3 in ward prac checked 4 hourly and charted ea shift #IVchat Wed Feb 2 17:51:07 PST 2011 InfusionNurse @Christinajoi... intradermal so low angle to skin surface... #IVchat Wed Feb 2 17:51:14 PST 2011
  13. 13. onlinenursing I am learning so much #nurses at tonight's #IVchat ! WOW! Wed Feb 2 17:51:25 PST 2011 holisticnurses @swan5675 That's great! Very helpful in the transition to home. #IVChat Wed Feb 2 17:51:44 PST 2011 IVchat T3 - share what u chart when observing PIV site? #IVchat Wed Feb 2 17:52:08 PST 2011 chemosabe T3 mostly I work in amb environment, therefore, sites checked EVERY time we go to patient and charted at discharge. #ivchat Wed Feb 2 17:52:33 PST 2011 swan5675 @holisticnurses Yes... tracking is even more important than ever these days, including reimbursement reasons #IVchat Wed Feb 2 17:52:48 PST 2011 IVchat RT @chemosabe: T3 mostly I work in amb environment, therefore, sites checked EVERY time we go to patient and charted at discharge. #IVchat Wed Feb 2 17:53:01 PST 2011 InfusionNurse yay good RT @swan5675: @holisticnurses Yes... tracking is even more important than ever these days, including reimbursement reasons #IVchat Wed Feb 2 17:53:19 PST 2011 swan5675 T3 "No redness, edema or drainage at site.... patent" #IVchat Wed Feb 2 17:53:30 PST 2011 chemosabe T3 skin condition, cannula condition, dressing state, leakage and how managed presence of exudate or blood #ivchat Wed Feb 2 17:53:33 PST 2011 Christinajoi @holisticnurses Hey #IVChat Wed Feb 2 17:53:56 PST 2011 VascularAccess T3 @IVchat ..like no swelling, infusing well, drsg intact?? #IVchat Wed Feb 2 17:53:58 PST 2011 swan5675 T3 Also add, "patient denies any discomfort at site" #IVchat Wed Feb 2 17:54:34 PST 2011 IVchat Leading on to T4 - if swelling, redness at site, is this a criteria for restarting site elsewhere? #IVchat Wed Feb 2 17:55:01 PST 2011 swan5675 T3 "PIVDD&I" #IVchat Wed Feb 2 17:55:17 PST 2011
  14. 14. chemosabe @swan5675 T3 Also add, "patient denies any discomfort at site" - NICE #ivchat Wed Feb 2 17:55:37 PST 2011 Christinajoi @InfusionNurse Ok thats what my instructors call 20 degree(close to skin) I like doing intradermal I get those right everytime : ) #IVChat Wed Feb 2 17:55:48 PST 2011 InfusionNurse Standard abbrev at ur hosp?? RT @swan5675: T3 "PIVDD&I" #IVchat Wed Feb 2 17:55:57 PST 2011 swan5675 @IVchat Absolutely! We restart when patient reports pain in absence of apparent problems.... #IVchat Wed Feb 2 17:56:13 PST 2011 onlinenursing T3 - Color, dressing, whether fluids are connected, pt tolerating, palpation, any edema, etc.. #IVChat Wed Feb 2 17:56:21 PST 2011 InfusionNurse @Christinajoi u just want a 'bleb" to numb the site... #IVchat Wed Feb 2 17:56:38 PST 2011 swan5675 @InfusionNurse Yes... standard approved abb. #IVchat Wed Feb 2 17:56:40 PST 2011 TriniRN @IVchat T3~in home infusions, pre, during and post infusion and upon D/C of cannula or huber needle..#IVchat Wed Feb 2 17:56:41 PST 2011 IVchat RT @swan5675: @IVchat Absolutely! We restart when patient reports pain in absence of apparent problems.... #IVchat Wed Feb 2 17:57:11 PST 2011 chemosabe T4 as I am playing mostly with cytotoxics yes EVERY time #ivchat Wed Feb 2 17:57:13 PST 2011 InfusionNurse RT @IVchat: Leading on to T4 - if swelling, redness at site, is this a criteria for restarting site elsewhere? #IVchat Wed Feb 2 17:57:40 PST 2011 swan5675 RT @chemosabe: T4 as I am playing mostly with cytotoxics yes EVERY time #IVchat Wed Feb 2 17:57:53 PST 2011 Christinajoi @InfusionNurse Ok Thanks #IVChat Wed Feb 2 17:58:05 PST 2011 InfusionNurse @swan5675 pain but with bld return at IV site? #IVchat Wed Feb 2 17:58:35 PST 2011
  15. 15. onlinenursing T4-Agree w/ @chemosabe depends on what is running-but if site makes me 'nervous'-D/C. If diff stick then need central line anyway #IVchat Wed Feb 2 17:59:06 PST 2011 IVchat Definitely need a good patent IV e/ execellent bld rtrn RT @chemosabe: T4 as I am playing mostly with cytotoxics yes EVERY time #IVchat Wed Feb 2 17:59:13 PST 2011 swan5675 @InfusionNurse Nope. Doesn't matter if there is blood return. Patient wants/needs a change, it gets done. #IVchat Wed Feb 2 17:59:38 PST 2011 TriniRN @InfusionNurse T4~I always do! Those are usually initial signs of infiltration.#IVChat Wed Feb 2 17:59:51 PST 2011 InfusionNurse T4 - use to be routine site rotation every 48-72hrs...now new standard says depend on site condition.. #IVchat Wed Feb 2 18:00:09 PST 2011 swan5675 @InfusionNurse Besides....I've had perfectly good IV sites that don't have blood return....although rare #IVchat Wed Feb 2 18:00:29 PST 2011 IVchat :) RT @TriniRN: @InfusionNurse T4~I always do! Those are usually initial signs of infiltration. #IVChat #IVchat Wed Feb 2 18:00:36 PST 2011 chemosabe @swan5675 pain or DISCOMFORT in absence of other evidence could just b local nerve irritation ?necessity 2 resite other than comfort #ivchat Wed Feb 2 18:00:45 PST 2011 IVchat RT @swan5675: @InfusionNurse Besides....Ive had perfectly good IV sites that dont have blood return....although rare #IVchat Wed Feb 2 18:00:57 PST 2011 InfusionNurse RT @chemosabe: @swan5675 pain or DISCOMFORT in absence other evidence could local nerve irritation ?nece 2 resite other than comfort #IVchat Wed Feb 2 18:01:42 PST 2011 chemosabe Adult CF team in my hosp only resite PIVC if necessary, had 1 last 11 days! #ivchat Wed Feb 2 18:01:42 PST 2011 IVchat **Shoulder tap** time is up...any parting thoughts??? #IVchat Wed Feb 2 18:02:34 PST 2011 swan5675 I never understood pt's describing pain 2nd day when no signs of problems at site.... UNTIL I was a patient and it happened to me #IVchat Wed Feb 2 18:02:48 PST 2011
  16. 16. InfusionNurse WOW...and no compli? RT @chemosabe: Adult CF team in my hosp only resite PIVC if necessary, had 1 last 11 days! #IVchat Wed Feb 2 18:02:49 PST 2011 swan5675 WOW... time sure flies when I show up late ;) #IVchat Wed Feb 2 18:03:13 PST 2011 momof2chocdivas @InfusionNurse Still teaching every 72 in school but the also emphasize depends on facility #IVchat Wed Feb 2 18:03:27 PST 2011 InfusionNurse RT @swan5675: never understood pts describ pain 2nd d when no signs of problems at site.... UNTIL was a patient it happened to me #IVchat Wed Feb 2 18:03:40 PST 2011 holisticnurses @chemosabe that was my q. odd site vs bandage vs nerve irritation vs infiltration. pt w/ iv can't distinguish types of pain. #IVChat Wed Feb 2 18:03:46 PST 2011 chemosabe @InfusionNurse apparenly not, same lad in currently and up to D5 #ivchat Wed Feb 2 18:03:49 PST 2011 holisticnurses Pt knows best about his/her experience in relation to discomfort and PIVs. #IVChat Wed Feb 2 18:04:20 PST 2011 onlinenursing @InfusionNurse actually our institution does 72 to 96 hours based on evidence for site change. #IVchat Wed Feb 2 18:04:30 PST 2011 TriniRN @IVchat great discussion! Learned about NS for local anesthetic:) will read more about this! Thx!!#IVchat Wed Feb 2 18:04:30 PST 2011 swan5675 RT @holisticnurses: Pt knows best about his/her experience in relation to discomfort and PIVs. #IVchat Wed Feb 2 18:04:46 PST 2011 InfusionNurse @onlinenursing there are new standards now..just released.. #IVchat Wed Feb 2 18:05:12 PST 2011 IVchat Many thanks to everyone..this has been a great chat...if u all r interested take a survey about SOP.. #IVchat Wed Feb 2 18:05:14 PST 2011 swan5675 IVs can last a long time, given excellent technique in prepping at start #IVchat Wed Feb 2 18:05:25 PST 2011 onlinenursing @InfusionNurse Link to new standards would be great! #IVchat Wed Feb 2 18:05:42 PST 2011
  17. 17. chemosabe @holisticnurses we all know that there are sites that tend 2 b more uncomfortable than others. just need 2 try 2 avoid them! #ivchat Wed Feb 2 18:05:48 PST 2011 InfusionNurse Yes, please take this survey....http://polldaddy.com/s/89911DF2E8D8ABEB #IVchat Wed Feb 2 18:05:49 PST 2011 swan5675 Thanks! Nice to see everyone again #IVchat Wed Feb 2 18:05:50 PST 2011 onlinenursing @InfusionNurse Thanks Cora for leading #IVchat this was wonderful! Good to 'see' ALL of you. Wed Feb 2 18:06:18 PST 2011 holisticnurses RT @InfusionNurse: Yes, please take this survey....http://polldaddy.com/s/89911DF2E8D8ABEB #IVChat Wed Feb 2 18:06:19 PST 2011 IVchat Next IVchat is on Wed. Feb. 17 - every other Weds. Good night to all!! #IVchat Wed Feb 2 18:06:33 PST 2011 chemosabe Queensland Health guideline is 48 hr resite, unless clinical judgement or medical order otherwise! #ivchat Wed Feb 2 18:06:57 PST 2011 InfusionNurse not avail on line but can be purchased...RT @onlinenursing: @InfusionNurse Link to new standards would be great! #IVchat Wed Feb 2 18:07:29 PST 2011 holisticnurses Thanks, Cora! Glad to see some familiar faces. This Telehealth nurse learned some great things tonight. #IVChat Wed Feb 2 18:07:29 PST 2011 chemosabe thank u everyone, sleep well in your snowy environs, & i'll get back in to real work #ivchat Wed Feb 2 18:07:49 PST 2011 swan5675 Nite....stay warm! #IVchat Wed Feb 2 18:08:08 PST 2011 InfusionNurse Thanks to all my buddies from twitter..good to see u..glad u all came!! #IVchat Wed Feb 2 18:08:38 PST 2011 InfusionNurse @chemosabe hey interested in the INS standards of practice? #IVchat Wed Feb 2 18:09:15 PST 2011 holisticnurses @swan5675 @chemosabe @onlinenursing @christinajoi Goodnight, all! #IVChat Wed Feb 2 18:09:49 PST 2011

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