Although there might be several policies related to healthcare services that need to be viewed or amended, the policy that peripheral I.V.s need to be changed every 72-96 hours based on the Center For Disease Control recommendations should be in that list. According to this policy, peripheral I.V.s should be replaced after the expiry of three to four days (Finkelman & Kenner, 2016) . However, this paper posits that the policy should be reviewed and changed to state that peripheral I.V.s replacement should be done in clinically-indicated situations. Studies have shown that many healthcare organizations have this policy already in place, which indicates that they are in agreement with the recommendations provided and outlined by the CDC.
According to the CDC, the replacement should be done without considering how the peripheral I.V. is functioning or whether or not there might be induration around the IV site. After twenty years of research on this issue, a study has shown that there are no benefits in routinely changing the peripheral I.V.s. The findings of the study also suggest that the recommended three-day replacement could be harmful. The study was conducted by The Lancet in September 2012. In the study, researchers found that the two approaches to managing the issue of peripheral I.V.s were “equivalent’. The two included changing the peripheral I.V.s as clinically indicated and changing them based on the CDC’s recommendations of every seventy-two to ninety-six hours (Finkelman & Kenner, 2016) . The results of the study showed that there were no differences noted in the main endpoints such as in occlusions, infiltration, infusion failure, bloodstream infection due to the catheter, all other infections in the bloodstream, the rate of mortality and the occurrence of phlebitis 48 hours after removal or during use. At the same time, the authors argued that if organizations were to adopt the approach of changing the peripheral I.V.s depending on the clinical indications, they would be saving not only their finances but also material resources.
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People Directly Addressed in the Policy
The policy that peripheral I.V.s needs to be changed every 72-96 hours affects two primary stakeholders in the healthcare organization. Firstly, it impacts the patients who attend healthcare facilities. The proper functioning of peripheral I.V. is pivotal in ensuring effective and efficient recovery process. However, this does not mean that replacement within three to four days should be the only mechanism of ensuring that peripheral I.Vs are working correctly. Patients need quality healthcare services at all times. On this note, it is their right to demand this basic service from the providers (American Association of Colleges of Nursing, 2009) . However, as is the case with insertion, replacement with no indication or clinical problem can trigger interference with the healing process and even worsen the patients’ conditions. Therefore, it would be pivotal to ensure that peripheral I.V. is replaced only when there are clinical indications. In this way, anxiety among patients will be managed and reduced.
On the other hand, caregivers are also affected by the policy. Since nurses and other providers must apply and follow the policies in their respective institutions, they find themselves in conflict with the patients or their families as well as their seniors in the healthcare facilities (Finkelman & Kenner, 2016) . Since peripheral I.V. may be working properly even during or after three to four days, they fail to understand why they need to replace them, which is a psychological torture to such caregivers.
The Needs of the Identified People
In the healthcare facility that I used to work in, there were complaints among providers that they were being called even at night to change the change peripheral I.V for patients. The main concern was that there was no indication of problems with patients’ peripheral I.V. At the same time, they complained that the policy was only based on recommendations given by one body among many other agencies in the healthcare industry. Therefore, the policy was ill-advised. The patients, on the other hand, raised issues on the replacement process. For example, one patient developed more complications after a replacement was done, which worsened the condition.
Policy Response to the Needs or Wants
The changing of this policy to replacement based on the clinical indications would go a long way in resolving some of the issues noted above. For example, providers and physicians will be required to replace them if there is any indication of complication such as infection or bleeding noted. The conflict with patients and organization’s management will be reduced. On the other hand, patients will be relieved of the interference with their conditions, which could worsen their situations.
Processes and/or Procedures Needed To Produce Results
In order to change the policy in the organization, there will be a need to sensitize both the professionals and patients. However, the views from all stakeholders will be taken before any implementation is done. In the process, all parties will be represented to reduce resistance. After changing the policy, caregivers will be empowered in the process and how it should be carried out.
Implementing the Policy
The Board of Directors will be responsible for endorsing the implementation of the policy. However, a committee will be formed to look into issues that will inform the need for a change. The committee will be well represented and will come up with a report and recommendations. The policy will, therefore, be changed after the Board of Directors accepts the proposals. Finally, the board will endorse the change. However, ample time will be given before implementation, for sensitization or clarification to any affected parties.
References
American Association of Colleges of Nursing. (2009). Nurse faculty tool kit for the implementation of the baccalaureate essentials. Retrieved
from http://www.aacn.nche.edu/education-resources/BacEssToolkit.pdf
Finkelman, A. and Kenner, C. (2016). Professional nursing concepts: Competencies for quality leadership (3rd Ed.). Burlington, MA: Jones and Bartlett
