Reply To: Issues with Peripheral IVs and Missed Secondary Medications

  • Mary Lynn Rae

    April 16, 2021 at 4:16 pm

    Hello JP:


    We did put the signs on the IV poles but then ended up disappearing so we now have just posters in the room and also on our GetWellNetwork TV


    For secondary medications:  I think this happens with new nurses so I always just try something simple:  you must see it drip before you walk out of the room….



    Mary Lynn

    Mary Lynn Rae, MSN, RN, NPD-BC, CPHON

    Nursing Professional Development (NPD) Practitioner/Clinical Educator Hem/Onc/SCT (LC17/LC18)

    Ann & Robert H. Lurie Children’s Hospital of Chicago

    T 312.227.4224 | |

    225 East Chicago Avenue, Box 248, Chicago, Illinois 60611-2991



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    Original Message:
    Sent: 4/14/2021 10:46:00 PM
    From: Jonathan McDaniel
    Subject: Issues with Peripheral IVs and Missed Secondary Medications

    Hey everyone,
         My name is JP and I’m a nurse over here at Helen DeVos Children’s Hospital in Grand Rapids, MI. I work on a 24 bed Heme/Onc and BMT floor as a bedside RN as well as a safety coordinator. I’m just reaching out to everyone cause I have two projects I’m starting to investigate. One a hospital wide project and the other a floor specific one. The first issue relates to peripheral IVs and the hospital having some pretty nasty infiltrations. After discussions and meetings, and doing a Direct Cause Analysis, we did some education with staff about our policy (q1 hr visual assessments) and management even put out a video but we were looking to do something a bit more tangible. Now as a H/O floor we are so used to central lines, so in contrast to the rest of the hospital, PIVs are actually the rarity versus the norm. What the other floors have done because of their rare experiences with central lines have developed a signage they put on the patient’s IV pole that is a visual reminder that this patient has a central line, so when accessing it for meds, make sure to clean the hubs and even wear a mask (the floors were having an increase in CLABSIs, which drove them to develop the sign). So with this in mind, we were thinking of developing some signage for patients with peripheral IVs as a visual reminder to pay special attention and assessments. Has anyone done anything similar or done anything else in relation to dealing with peripheral IVs? Just looking for some ideas.
         The second question piggy-backs on the first because we have had consistent issues related to nurses having secondary medications and forgetting to unclamp the secondary tubing, thus having the pump only pull from the primary bag and not the secondary med. Any one have similar issues and what have you done in response? These are more likely antibiotics so having an independent double check seems unattainable just in terms of the amount of meds and limits on getting someone to double check every medication. Any thoughts? Thanks so much everyone.

    JP McDaniel, RN, BSN, CPHON
    High Reliability Mentor
    Helen DeVos Children’s Hospital

    Jonathan McDaniel, CPHON,RN
    Comstock Park, MI
    United States