Here's something you don't wanna be: the first patient when a nurse starts using a new IV catheter.
Our hospital (read corporation) has switched IV catheters to a bulky new catheter with an extension tubing on it. There is a lot more to it than the catheters we used to use. A lot more steps. To say we are fumbling with it is to understate it. I'm good at IVs. So far my 1st time stick success rate is oh, I'd say, 30%. We are not having trouble getting in, but then the vein blows. Its like they have decided to buy a catheter that is the most idiotic design ever. Typical hospital corporate crap.
Here's a example of a couple of instruction steps:
-Hold onto stabilization platform and push tab component prior to breaking seal
-Breaks seal by pulling back on finger grips approximately 1/8" then pushes all
pieces together tightly
-Places pad of index finger (1 hand technique) or thumb of opposite hand (2-hand technique on push tab to advance catheter down and forward
And this is only 3 of 20 steps.(Just shoot me now..) Why does this remind me of late Christmas Eve trying to put together a toy?
Our concern: critical patient and no one can get the damn thing in. Here is an example of corporate cost saving mentality: instead of staying with something that works, go to one that is a bad design to save money. Now I realize that no one likes change, you need to adjust to new products, but this catheter sucks.
Alas, the poor patients are our guinea pigs. Unfortunately, that's the way it has to be. The patient is cranky. I'm cranky. Isn't life grand...
6 comments:
Why not practice on the bean counter that decided to buy that shit rather than the patient?
If that doesn't work, practice on each other. You're more apt to get used to it and get it right sooner if you know your coworker that you just stuck the thing into might slap the dogshit out of you for screwing it up.
Have a nice weekend madness,
:-)
Joe
Our hospital went with a clumsy craptastik new iv cath about 9 months ago. Surely the thing is cheep, but like you said in your experience they just plain suck. Poor ergonomics, poor function, poor engineering, etc. Our infirmary sent some dingle of a rep to demo the device...When he was telling me how "he would do it" I asked how long it took to feel comfortable/proficient with them. and he said "well I am not clinical, but the way it is designed to be used is....blah blah blah. I quickly realized he would have nothing informative to teach me. Also the time to get labs sucked because in our smaller facility we draw most of our own specimens, and the critical pts needing intervention now, got poked over needlessly, of course the brilliant folk who planned this switch decided it would be best to make sure any stashes of the old IV's got removed from the ER. So after a few days our better stashed stashes got used up, and it was sink or swim with the wonderturd...
I can't imagine how the combined attributes of a very sharp needle, long azz bevel, and slow as dirt flash chamber would add up to a positive product....Sorry to ramble Madness, this topic just hit home...
Sounds like we have the same IV caths. And its really funny because after we used the old IVs a couple of times, they are no where to be found....the reps from this company are obnoxious and way too aggressive. We call them the IV nazis. They ask you "DID YOU START ONE? DID YOU START ONE? CAN I WATCH YOU?!!!!! I gonna slap one of them.
We went to the kind that are spring loaded last year and prevents needle sticks. We work with a needleless system where you plug a syringe into a port .
They are BD insytes and i went from getting every IV to getting none. Just getting used to the now
They are here; http://www.bd.com/infusion/pdfs/D14442.pdf
Our ER just went with the BD Nexiva Closed Catheter System. THEY SUCK! Besides the fact that they don't thread well and blow the vein often, plus have flimsy catheters that will literally flip over in the vein.....
The other problem is, when you have a combative patient and they pull the IV out as you are trying to insert it, there is no way to quickly retract the needle. So in a trauma situation really, any situation, you have a sharp that can't be retracted using one hand.
Suck. Hate.
I found your post really interesting and it has really improved my knowledge on the matter.
http://www.youtube.com/watch?v=EyuUyN5RVTI
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