Catheter Alert
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) reviews serious events in hospitals that adversely affect patient outcomes. One type of event that seems to be occurring with increasing frequency and has resulted in patient deaths, is the inadvertent infusion of tube feedings or other non-IV fluids into Hickman catheters in hospital.
Naturally, we at the Oley Foundation are concerned and are looking into what steps we as an organization can take to prevent these mistakes. Another threat that consumers continue to relay to us, is the increased risk of line infection when hospital personnel access their lines. For now, we are recommending a few preventive steps you can take, should you go to the hospital for testing or are admitted for a procedure and/or emergency health care:
1. Be Vigilant
Ask hospital staff what they are using your line for before they access it. Be vigilant about their septic technique as well, before allowing them to touch your line. If possible, have a friend or family member with you before and after procedures when you are not alert enough to protect your access yourself.
2. Communicate with Clinicians
Share your concerns about misuse of your IV line. Ask the head nurse on your floor and/or in the laboratory/examination area, "What steps does your institution take to insure that you do not infuse non-IV fluids into IV catheters?" Ask what steps they take to prevent line infections. Write down your catheter access/dressing change protocol and share it with the hospital personnel caring for you. (It helps to have your physician sign it.) Also, if you and your physician have placed restrictions on your line, such as no blood draws, be sure this is communicated to hospital staff and on your personal protocol sheet.
3. Tape IV Line Above the Waist
Tape your catheter tubing to your chest, arm (wherever most appropriate), above the waist and far away from any other tubes or ostomy appliances. When you are hooked-up to IV fluids, secure the catheter to the outside of your hospital gown to avoid tugging and pulling. If you have a feeding tube in addition to your catheter, keep it taped in place, away from the IV.
4. Label Your Line
Wrap a piece of tape on the soft part of your catheter, at least 1-inch above the hub, such that it sticks out, perpendicular to the line (like a clothing tag), and print "FOR IV USE ONLY" on it in large letters. Show this label to any clinician who wants to access your line. If you have a feeding tube as well, label it in a similar manner "FOR ENTERAL USE ONLY."
5. Be Creative
Brainstorm with family members, clinicians or other consumers and share your ideas with Oley; call (800) 776-OLEY or email the LifelineLetter Editor at DahlR@mail.amc.edu.