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What training do you need to manage an intravenous infusion?

  • Comments (68)

Article: NICE launches draft guidance on IV fluids for clinicians

Hospital patients who have problems with fluid balance are having their lives potentially put at risk by overstretched or under trained NHS staff, the National Institute for Health and Care Excellence has warned.

They have issued draft recommendations for management of intravenous infusions which are due to be published later this year.

 

What do you think?

  • Do you have time to monitor and assess patients receiving intravenous fluids?
  • Are patient ever put at risk because of poor management of intravenous infusions?
  • Have you received any training to manage intravenous infusions?
  • Do you feel fluid balance is adequately monitored in your clinical area?
  • Comments (68)

Readers' comments (68)

  • Anonymous

    Is it seriously being suggested that RN's are incapable of managing simple IV infusions?

    Guess it really is time to retire!

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  • Anonymous

    anon 9.17 - unfortunately I suspect the answer is yes, otherwise patients would be well hydrated all the time, receive fluids on time running at the correct rate, venflons would not become infected, fluid charts and daily weights would be accurate and monitored daily with any concerns raised to the doctors and acted upon. Signs of dehydration or fluid overload would be recognised and blood results would be monitored correctly.

    The need for IV fluids might may not even be appropriate if patients were given plenty of drinks in the first place.

    You need to remember that MANY nurses working on the wards have not received IV training so it is often left up to one nurse to manage all the IV fluids and medication which cannot be safe.

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  • Anonymous | 27-May-2013 11:27 am

    Am I hearing you correctly ?

    "You need to remember that MANY nurses working on the wards have not received IV training"

    Where are these nurses coming from ?

    Is it true that the universities are failing to provide an appropriate education?

    Are we producing "incompetents?" what else is missing from these "nurses" education" ?

    Maintaining simple IV infusions is not rocket science and neither is recognising a state of dehydration/circulatory overload !

    Did you mean to talk about haematological parameters /blood chemistry when you you talk about "blood results" ?

    If "nurses" cannot manage IV fluids (simple) because they have not been "trained" then it is highly unlikely they will have been "trained" to understand complex laboratory reports which have, in the main, been produced by Laboratory Scientists on the same pay grade as nurses! When did you last hear of a of the Lab making "errors" ?

    Maybe the critics of nursing as a profession are right and you (Anonymous | 27-May-2013 11:27 am) have just succeeded in providing another stick which the critics will use to beat the profession

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  • Anonymous

    Jenny - Didn't you have to undergo training in the administration of IV fluids/medication - which is usually done post registration, involves study days, completing a workbook and practical training or did you receive your IV training whilst still a student? Surely until you are fully trained you cannot administer IV's, you must know this? Do you think it is the universities responsibility to train student nurses in IV therapy?

    Who would you regard as more 'incompetent' - someone who is not yet trained in IV management or someone putting up IVs who is not trained to do so?
    What do you regard as 'simple' IV fluids? is it the fluid they are given, the method it's given by, and what do you look out for when administering IV fluids?
    What training did you think you needed to interpret blood chemistry results?

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  • I trained in the '70's & as student nurses we did know about IV infusions in respect to what to check for, when not to give & how to calculate the amount of drops per minute as we did not have any machines to do it for us (the nearest we had were soemthing called 'gate clamps' Rememberm them?) ect.
    We were involved with the support/supervision of a trained nurse, at a level appropriate to our year of training. This was for fluid but not drugs because at that time even as trained nurses we did not give IV drugs until years later.
    For this additional responsibility we were given additional/top up training/education before we were allowed to do this.

    So as giving IV drugs, taking blood etc is now so much a part of every nurses day to day duties (and for which, I say again, we did not get any addition staff nor was anything removed, it was just absorbed into the 'role of the nurse'), should they not be 'trained' about IV infusions both in university & practiacally on their placements?
    Therefore, I wonder, does this not depend on where you trained, if some people are saying that new nurses dont have the knowledge? Patients are now so much more high dependency that I find it hard to believe students have not had lot of experience of patient with infusion of many sorts.
    Plus, would a nurse be expected to know the full details of a lab result (unless they were in ITU or very experienced), so long as they have a basic knowledge of them for their area, is that not what the doctor is for? The nurse needs to bring anything they are concerned about (they might not know the whole reason why) the attention of the doctor whether it is the patients condition or what they might have seen on the report & ensure it is acted upon.
    We need to not lose sight of the title 'Nurse' not 'Scientist' or tech.

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  • Anonymous

    Ann Kirk and Jenny Jones, registered nurses have to undergo additional training/assessment to administer ALL medication by all routes after they have registered. Student nurses may only administer oral, im, sc, pr meds under supervision. They are taught how to calculate drop rates and set up infusion pumps and syringes, they can act as second checker for 0.9% saline only, they cannot connect the giving set to the patient.
    There have been times whilst working in an Emeregency Room (resus) where I have been the only person able to give medication intravenously.

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  • Anonymous

    in many places I have worked (as an RN) student nurses no longer administer any form of medication. they are not allowed to be a second checker for CD drugs or IV drugs/fluids, we were allowed to do this when we were students but that was back in the 80's.

    anne kirk - times have changed, nurses are no longer allowed to administer medication of any kind until they have received the training and are deemed competent, that includes IV fluids which is of course classed as medication. nurses who have not received further IV therapy training cannot second check IV fluids or IV medictaion in many trusts.

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  • Anonymous

    Ann Kirk and Jenny Jones. You are absolutely spot on. Pretty unbelievable, isn't it?

    Unfortunately, we live in a time where important nursing skills and knowledge are simply not being taught or included in essential training for students. Without the required "study days, workbook and everything", registered nurses believe that they are "not able" to carry out previously routine nursing skills. A lucrative business around perceived enhanced roles, particularly in the NHS, has grown up. Without a certificate, you are nothing.

    Times have indeed changed and we are not keeping up. UK Nursing is sliding further down the global ladder. That is a sad fact. If we require "study days with workbook and everything" to carry out what should be essential skills learned as students, it is easy to see why.

    I say this as an ANP (trained in the 80s, gained my degree and then my masters in the ensuing years)working in ED. I have certificates up the wazoo. Most of which are useless, unnecessary and have contributed nothing to my existing knowledge and skill base, but have been necessary to complete (again and again, because they change them every couple of years you know!) due to stupid policies which constrain and diminish our profession. It is a ridiculous situation ans so few question it.

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  • Anonymous

    Since the review of IV care/issues is looking at the present day situation I think there is little value in talking about what nurses where thought/and how they were thought in the past. We need to look at what nurses are, or, are not being thought now. Hospitals need to ensure that nurses are deemed competent before they take on the responsibility of administering IV medications and fluids. These may be "routine" but nurses need to be trained and competent. I find it rather alarming that nurses who are not deemed competent to administer IV fluids/medication are deemed competent to act as the "second checker" surely one must be competent to carry out the task before one can be deemed competent to check another person's ability to carry out the task. In Canada, where I now work, we only double check narcotic's, chemo, blood products etc. I cannot understand why one would need to double check normal saline. I worked in Ireland recently & found it challenging because on some shifts there was only one nurse who could administer IV meds and this resulted in some very unsafe practice and IV meds were never administered on time which must have a negative impact on their effectiveness. I agree that this issue warrants attention.

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  • OK --- I hear you !

    You are telling me that the modern day, expensively educated, degree bearing nurse graduate needs further "training" before being deemed " competent in administering medication and IV fluids. WHY?

    Perhaps I should ask exactly what these "RN's" are capable of undertaking ?

    Am I correct in thinking these individuals are pretty useless and their "degree" is not worth the paper its written on ?

    Is it time to review our university education and ensure that the system produces graduates who are "fit for purpose" ?

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