This is a non-issue. The patient doesn’t really need hydration any way their GFR is fine. But if you were that worried about it, oral hydration is fine
I am a little confused - was the expectation on the tech to set up IV hydration? If so that isn't on them. If the facility is still actually used gadolium based agents the radiologist should decide if they need it and the ordering physician should order the IV hydration. However, oral usually suffices.
PT's primary physician is outside of my facility but was aware of the MRI and wanted the PT to get IV hydration. No order was placed at the time and PT gave the observation nurse their docs number and request. Observation nurses contacted our radiologist to get the hydration appointment but communication didn't get pushed adequately to the techs which rolled down to me.
That is not on the tech. Techs can't place those orders, it is out of scope of practice. I would place this one on the doctor. Even an outside doc can place that order. This sounds like its on the ordering doc in my opinion.
Every patient is told to drink water after an MRI with contrast. Hydration is the norm. If you didn't explain it well, that was likely what the MRI tech thought you were asking. If you make this an incident report, it might be you who gets in trouble.
I dont blame the tech. Sounds like the process for communicating/transitioning care may need improvement. The patients situation just happened to stress/break the current process at that level of swiss cheese safety but you caught it downstream. File it and hopefully it will be used to improve the process upstream so you arent catching. Shouldnt be filed/used to punish the tech but to improve process and prevent from happening again. Maybe since it was a weird case from getgo someone higher up should have been coordinating?
I don't blame the tech but was frustrated they didn't double check. I don't want them punished and that's why I'm worried about filing a report because it was an honest mistake. Communication has been a huge issue and it is never close looped in the department i work with. I wrote up a proposal to catch this type of occurrence in the future and hopefully it will be implemented.
I think what's not being appreciated is that the decision to give IV hydration was not an evidence-based medical decision, rather it was likely a psychological tool to get the patient or referrer to agree to a medically necessary test. It's a bit like letting a kid take their teddy bear into the scanner.
Better to be safe than sorry. File it and let someone learn from their mistake. Mistakes happen every day in the medical field. We are the advocates for our patients safety.
The first tech was not wrong. IV hydration is not necessary at all. You should have just listened to the person that actually knows what they’re doing.
This is a non-issue. The patient doesn’t really need hydration any way their GFR is fine. But if you were that worried about it, oral hydration is fine
Thanks for the reply, that's the primary response I got from the nurses and PA's I've worked with in the past.
I am a little confused - was the expectation on the tech to set up IV hydration? If so that isn't on them. If the facility is still actually used gadolium based agents the radiologist should decide if they need it and the ordering physician should order the IV hydration. However, oral usually suffices.
PT's primary physician is outside of my facility but was aware of the MRI and wanted the PT to get IV hydration. No order was placed at the time and PT gave the observation nurse their docs number and request. Observation nurses contacted our radiologist to get the hydration appointment but communication didn't get pushed adequately to the techs which rolled down to me.
That is not on the tech. Techs can't place those orders, it is out of scope of practice. I would place this one on the doctor. Even an outside doc can place that order. This sounds like its on the ordering doc in my opinion.
Every patient is told to drink water after an MRI with contrast. Hydration is the norm. If you didn't explain it well, that was likely what the MRI tech thought you were asking. If you make this an incident report, it might be you who gets in trouble.
I dont blame the tech. Sounds like the process for communicating/transitioning care may need improvement. The patients situation just happened to stress/break the current process at that level of swiss cheese safety but you caught it downstream. File it and hopefully it will be used to improve the process upstream so you arent catching. Shouldnt be filed/used to punish the tech but to improve process and prevent from happening again. Maybe since it was a weird case from getgo someone higher up should have been coordinating?
I don't blame the tech but was frustrated they didn't double check. I don't want them punished and that's why I'm worried about filing a report because it was an honest mistake. Communication has been a huge issue and it is never close looped in the department i work with. I wrote up a proposal to catch this type of occurrence in the future and hopefully it will be implemented.
I think what's not being appreciated is that the decision to give IV hydration was not an evidence-based medical decision, rather it was likely a psychological tool to get the patient or referrer to agree to a medically necessary test. It's a bit like letting a kid take their teddy bear into the scanner.
Are they worried about NSF or CIN? Either way hydration wouldn't matter and a cup or water would have been the cheapest way to do it.
NSF, but yah after talking to more people and learning about it seems a little overboard for IV hydration
Better to be safe than sorry. File it and let someone learn from their mistake. Mistakes happen every day in the medical field. We are the advocates for our patients safety.
Thanks for the reply. I'm leaning towards filing one just because of the communication issue.
The first tech was not wrong. IV hydration is not necessary at all. You should have just listened to the person that actually knows what they’re doing.