A patient on your unit you are caring for has had his peripheral venous catheter in place for approximately 100 hours. The catheter looks normal and the vein is open. Tell me how you proceed with administering more IV medications.
In order to help prevent nosocomial infection, which is an infection a patient acquires while receiving care in a hospital, peripheral catheters should be replaced every 72-96 hours. If not changed, the IV catheter may become infected and cause the patient's hospital length of stay to increase or could even cause death in extreme cases. Although a peripheral catheter may look normal and the vein may be open, it is imperative the catheter be changed. The interviewer is asking this question to determine if the candidate understands the importance of changing peripheral catheters on time in order to prevent infections. To successfully answer this question, the candidate should indicate they would change the catheter, specifically noting that the catheter should have been changed at a maximum of 96 hours.
"This patient's peripheral venous catheter needs to be changed, no matter how good it may look. Unfortunately, you can't see bacteria, and these types of catheters are prone to infection, so they must be changed often. In fact, this patient's IV catheter should have been changed prior, as they shouldn't be inserted more than 96 hours. I typically change my patients' IV catheters every 72 hours, which is at the low-end of the suggested range for changing, just as a precautionary measure. So in this case, I would change this patient's IV catheter before administering anymore medication and change it every 72 hours after that."
"Although I would be glad that the patient's peripheral venous catheter site does not show signs of infection, this site can't be used anymore. It's an infection risk to keep the same peripheral venous catheter in place for over 96 hours. Before administering IV medication to the patient, I would change the site, making sure to place the date and time both on the dressing and in the electronic medical record. Because I may or may not be the patient's nurse it's time to change the IV catheter, I could also write 'change by ___ date at ___ time' on the dressing, to better ensure that the IV catheter would be changed within 96 hours, or sooner if that is unit policy. Changing IV catheters per unit policy is one of the important ways that we as nurses can prevent infections and phlebitis in our patients."
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Anonymous Answer
So IVs should be changed every 72-96hs regardless of the patent to help prevent nosocomial infections as an iv is an entry point for bacteria. I would therefore remove and resite the iv prior to giving intravenous medication. The longer it remains insitu the higher the risk. If the patient is requiring long-term Iv meds I would speak with the doctor to see if. a PICC line might be a better option.
Cindy's Feedback
Great! This answer has the right combination of what and why to demonstrate a deep knowledge of the subject.
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