..many facilities/organizations have them, some don’t. Many nurses know what their IV policies and procedures are, others don’t have a clue or don’t even know they should have one. Others say…yeah, we do have them but here’s what we do!
Borrowed from a previous post- “Terms of Confusion” about Policies and Procedures:
Policies are the established rules that guide the organization in the delivery of care. Policies are not negotiable and not modified unless it undergoes an official review or revision. Procedures contain a series of precise steps that outline the recommended manner in which the pyschomotor skills should be performed by healthcare providers.
We all know about policies and procedures and in theory, all nurses follow the policies and procedures in their work areas/facilities. However, many nurses have variations in practice and/or how they carry out the procedure. It is this variation (variance) that allow flexibility in practice that makes it “work” for the nurse. An example is how one nurse may have a habit of inserting an IV catheter bevel down, even though the approach varies from the practice documented in the organization’s policy and procedure manual. The nurse’s approach in the scenario works for her/him as she/he was able to successfully insert a peripheral IV.
These variations in practice happen all that time with many nursing procedures we do daily and it goes unnoticed until…….SOMETHING GOES WRONG….TERRIBLY WRONG!!! Suddenly, the whole picture changes and lots of blame will go around. The variations will be highly illuminated because the investigating committee (or a lawyer) found there is policy and procedure but the nurse did not precisely follow the procedure, hence the “negative” patient outcome. In certain situations, there are policies and procedures present but are conflicting in nature. An example is when two different departments are allowed to perform the same procedures in different ways resulting in patient or staff injuries.
Then, there is the ” no we didn’t know we should have a policy/procedure for that” scenario coming from the nursing leaders themselves. Sad but true, which makes you wonder, how do the staff know what to do? When you ask the staff nurses, their response - “I’ve done this at the other place (employment) and this is how we did it there”.
While we are on this topic…facility/organization nursing policies and procedures, general or IV specific, should not only be present but must reflect evidence based or best practices. This can be an enormous task and often, many resort to purchasing these products. While that may be the easy solution (and may look good on paper or electronically), ensure that the policies and procedures reflect what your organization actually does.
One last point, when the going gets tough, nursing education/training budgets are cut back, so even if the policy and procedure manuals are up to date, the staff are not educated/trained, which ultimately affect the quality of care.