Legal, ethical and documentation aspects on IV Therapy

3. Legal
Ethical
Documentation

4.  4 arenas of Accountability
To the public
To the patient
To the employer
To the profession

5.  Prepare, initiate ( Emergency & Critical area ) and
terminate IV therapy based on physician’s written
prescription.
 Determine solution and medication
incompatibilities.
 Assess all adverse reactions related to IV therapy
and initiate appropriate nursing interventions.

6.  Administer medications, chemotherapeutic drugs, flow
rates of solutions, compatible blood/blood components
and parenteral nutrition as prescribed by the physician.
 Adhere to established infection control practices.
 Maintain proper care of IV equipments.
 Document relevant data in the preparation,
administration and termination of all forms of IV therapy

7.  Wrong drug route
 Inappropriate timing
 Wrong drug name , looks alike name
 Wrong dilution fluid type/volume
 IV cannula inappropriate size and location
 Not calculated fluid rate*
 No label of dilution*

8.  Lack of confidence
 Negligence
 Tubing more than allowed*
 Not following aseptic precautions*
 Not documenting accurately
 No regular assessment & follow ups*
 Legislation impractical

9.  Code of professional conduct adherence
 Reading
 Asking to alleviate doubt
 Listen to the patients complaints carefully

10. Rights
Drug
Route
Doc
Dose
Time
Patient

11.  Lawsuits or suing by patients
 License withdrawal
 Profession risks
 Loss of Confidence from Public

12.  In 1993 Los Anglels ,continous infusion
of 145 mg morphine over 18 hours led to
patient’s death.
 Discuss why !!!!!

13.  Wrong dose of xylocaine given to patient,
order is 100 mg ,, the nurse injected 2
gram IV .

14.  A nurse failed to clamp a pump regulating
the flow of inj.Gentamycin to a child
through central line,
The child became totally deaf due to over
dose seven times duoble the prescribed
dose

15. • ER Nurse misplaced IV Line and fluid
infiltrated into patient’s hand resulting in
reflex sympathetic dystrophy ..
• The patient could not return to work and
won 702000 USD

16.  Following the standards of practice
always is the best method to protect your
self & your patient
 Listening to the patients is crucial part of
your assessment and care.
 Disinfecting cannula covers or IV ports
is a healthy practice prior to & after use
 Flushing of IV catheter after giving drugs
prolong the life and patency of catheter

17.  As a practioners , you are required legally
to document the following:
› cannula size & location
› Date & time
› Solution/drug type
› Additive added
› Flow rate
› Device used
› Patient teaching

18.  IV cannula labelling
 IV Therapy maintenance documentation:
› Site condition
› Site care provided
› Dressing changes /tegaderm or plaster
› Site changes
› Flow rate
› I/O details
› Tubing & solution changes
› Patient teaching

19.  Labeling bottles of fluids/drugs is very
critical, can’t be neglected:
› Patient’s name
› ID no
› Bed no
› Date & time hung
› Any additive added
› Flow rate
› Time started
› Sequential contained no
› Your name
 Do not put the labler over the fluid type

21.  Intravenous therapy Course Manual,2004,
Training Directorate, SQUH, Oman
 I.V Therapy made incredibly easy,
1998,springhouse, USA
 Ramona Heidi C Palad,2011, The ethico-legal
aspects of IV Therapy, power point
presentation, accessed on 3/2/2013,
http://www.slideshare.net/uglykidbhong/the-
ethico-legal-aspects-of-iv-therapy