Issue:  frequently adult Rapid Response RN is asked to administer tPA to occluded lines with the following ---

 

1. occluded line left over from night shift that line is not working

2. primary RN then has to contact team to write order for tpa (night shift often postpones this because the don't want to bother team in the middle of the night for this issue)

3. order frequently written incorrectly

4. delay in tpa being dispensed to floor (not currently stocked in med PIXYS)

5. Rapid response RN frequently busy with medical emergencies and cannot get to this task right away

5. HOURS of DELAY in administration of tpa

6. often results in missed meds, missed labs (or unnecessary needle sticks) and

7. increased risk for CLABSI to develop

 

Recommendation:   include PRN order for tPA in PICC order set (consider PRN for all central lines), stock floor med PIXIS with tPA, train nursing staff to recognize issue early to prevent line malfunction and potential CLABSI.