HospitalInspections.org

Based on hospital policy and procedure reviews, medical record reviews and staff interviews, the nursing staff failed to maintain intravenous sites per hospital policy in an order to ensure safety for 2 of 6 patients with intravenous lines. (#2 and #13).
The findings include:
Review of current hospital policy "Intravenous Therapy, Peripheral" approved 08/07/2013, revealed "Site Management: 4. Change sites at least every 96 hours, or as venous access allows. 5. If unable to rotate IV site due to difficulty in obtaining a new site, obtain a physician order to keep current IV in for greater than 96 hours indicating acceptable time frame and notify physician of possible need of a central line."
1. Review of medical record for patient #2 revealed #20 gauge (size of intravenous needle) inserted in right antecubital (surface of arm in front of the elbow) after first attempt on 03/25/2015 at 1840 in Emergency room.
Observation on 03/31/2015 at 1130 revealed IV (intravenous) site was currently in right antecubital area.
Interview of AS #1 on 03/31/2015 at 1450 revealed IV (intravenous) site had not been rotated since 03/25/2015. (6 days ago). Further interview revealed no order from physician to extend IV time frame or delay rotation.
2. Review of medical record for patient #13 revealed #20 gauge inserted in left wrist on 02/22/2015 at 0400 after two attempts. IV was removed from left wrist and changed on 02/28/2015 (6 days after initial) at 1101 in right hand with #22 after 1 attempt. Further review of medical record revealed no order from physician to extend IV time frame or delay rotation.
Interview of AS #2 on 04/01/2015 at 1000 revealed IV remained in patient's right hand for 6 days.
NC00104766