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7/17/2013 |
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In This Issue
• Learning About Clysis
• Making Sense of IV "Certification"
• Latest News & Blog Posts
• Featured Author - Pam Clark |
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The Resurgence of an Old Hydration Technique - Hypodermoclysis
With the hot days of summer approaching- keeping our elderly hydrated becomes critically important. Often an acute illness affects the ability of an elderly client or resident to keep up with the demands of sufficient water intake by mouth and rehydration via another means become necessary. |
Anyone who has attempted an IV catheter insertion on an elderly dehydrated patient is very familiar with the frustration and often the impossibility of the task. Due to the fact of very difficult cannulations on dehydrated individuals, we are seeing a resurgence of an old technique of rehydration called Hypodermoclysis or sometimes simply called “clysis”.
This strange sounding technique is actually a simple, easy, cost effective method of rehydrating with subcutaneous fluids. With clysis an insertion of a catheter subcutaneously is all that is required and is the rehydration technique used in many long term care facilities and home health agencies across the country to prevent a hospital admission for IV placement and hydration. Reducing unnecessary hospitalizations is a major focus in the health care industry today and many facilities are finding clysis as a great tool in their arsenal of hospital prevention strategies.
Generally, the literature states that the appropriate solutions that may be infused subcutaneously are isotonic solutions containing sodium chloride. However more recent studies have included solutions of D5W, Ringers, Lactated Ringers and solutions containing potassium chloride as acceptable solutions for clysis use.
The Advantages/Disadvantages of Clysis
Advantages
• Lower costs; fewer re-sites, less equipment required, less staff time
• More comfortable than IV administration
• Less likely than IV administration to cause pulmonary edema or fluid overload
• Simple insertion, less distressing than IV insertions
• May be administered in any care setting
• Does not cause thrombophlebitis
• Not associated with septicemia or systemic infections
• No danger of intravenous clot formation, and clotting of IV catheter
Disadvantages
• Limited volume of solution that may be administered
• Edema at infusion site
• Possible local reaction
Summary
Clysis is cost-effective, easy to administer, and safer than intravenous rehydration, but many nurses, nurse practitioners and even physicians are unfamiliar with the therapy. With the many advantages of this rehydration technique, it may be beneficial for facilities to take steps to educate their staff in this simple method of rehydration.
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Making Sense of IV "Certification" for LPNs/LVNs
You’ve worked long and hard to become an LPN/LVN. Now you want to expand your education and role and begin performing IV therapy with patients. This is why many LPNs/LVNs ask the question, “How do I obtain my IV certification?”
This can be a confusing topic, and here we will try to make sense of this process. |
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When we talk about IV “certification,” that is really a misnomer. In MOST states there is no actual “certification” given to LPNs/LVNs to be able to perform IV therapy. The nurse must be aware of the rules provided by the Board of Nursing for the state in which he/she practices, as every state’s rules vary slightly.
There are three separate components involved to be able to legally perform IV therapy on patients as an LPN/LVN.
Let’s start with education; always a good place to start. In most states the college curriculum to obtain your nursing LPN/LVN license contains some infusion therapy principles. This varies greatly from college to college, as well as state to state. Most state boards mandate that to be able to perform IV therapy on patients, the LPN/LVN complete additional education beyond the education needed to become an LPN/LVN. This education provides the knowledge and competency necessary to qualify the LPN/LVN to administer IV therapy. The Board of Nursing in some states requires the I.V. course curriculum to be approved by them and have very specific content requirements. This is why it is important to know exactly what YOUR state requires before practicing IV therapy as an LPN/LVN.
The second part of becoming qualified to perform IV therapy as an LPN/LVN is competency demonstrations. This is what you might think of as a skills competency check-off or validation. The skills check-off is to be performed under the supervision of a preceptor with appropriate infusion therapy knowledge and skills. This is where you will put into practice all the great information you learned in your additional IV education class; the preceptor then ensures that you are knowledgeable and safe to perform IV therapy on patients!
The third aspect of being able to practice IV therapy on patients is making sure that tasks performed by you as an LPN/LVN are within your legal scope of practice as defined by your State Board of Nursing. This is where it gets tricky! Pedagogy has provided links to each and every state’s Board of Nursing website. Here we summarize for everyone the requirements for each state for a LPN/LVN to be eligible to perform IV therapy and the tasks that are legal for your scope of practice in your state. Some states very specifically define what an LPN/LVN is able to do regarding IV therapy, and some states say that each facility may make its own decision as to which tasks an LPN/LVN may perform regarding IV therapy. These requirements are defined within each facility’s policy and procedures. We have made this easy for you; with just a click on your state, we take you to state-specific information so that you can make sense about how to begin performing IV therapy! Find your state and specific information under our Resources and "State Boards of Nursing".

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Blog Posts
You’ve worked long and hard to become an LPN/LVN. Now you want to expand your education and role and begin...
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Featured Author: Pam Clark
Pamela Clark
RN, BSN, CRNI
Pamela Clark, CRNI, is a Nurse Supervisor for Accredo, a leader in specialty pharmacy care. She has more than 28 years of experience in infusion therapy and infusion education with both licensed nurses and patients. Her experience spans multiple infusion settings including: acute care, long-term care, home infusion, and ambulatory infusion care. She also has experience in oncology and oncology research.
Pam has been active in the Infusion Nurses Society, both locally and nationally. She currently sits on the Journal of Infusion Nursing editorial review board, is secretary of the Greater Houston INS Chapter, and has experience as a presenter at national INS conferences on various infusion-related topics. Ms. Clark holds a Bachelor’s Degree in Nursing from
The University of Texas System School of Nursing at Austin. She has been certified in Infusion Nursing by the Infusion Nurses Credentialing Corporation for more than 25 years. |
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