/clinical/,/clinical/cckm-tools/,/clinical/cckm-tools/content/,/clinical/cckm-tools/content/delegationpractice-protocols/,/clinical/cckm-tools/content/delegationpractice-protocols/inpatient-delegation-protocols/,

/clinical/cckm-tools/content/delegationpractice-protocols/inpatient-delegation-protocols/name-97338-en.cckm

201712346

page

100

UWHC,UWMF,

Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Delegation/Practice Protocols,Inpatient Delegation Protocols

Peripheral Vascular Surgery/Neurosurgery Discontinuation of Radial Arterial Line - Adult - Inpatient [135]

Peripheral Vascular Surgery/Neurosurgery Discontinuation of Radial Arterial Line - Adult - Inpatient [135] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Delegation/Practice Protocols, Inpatient Delegation Protocols




Delegation Protocol Number: 135

Delegation Protocol Title:
Peripheral Vascular Surgery/Neurosurgery Discontinuation of Radial Arterial Line - Adult - Inpatient

Delegation Protocol Applies To:
UWHC Adult Vascular Surgery & Neurosurgery (Inpatient, Outpatient Short Stay) patients

Target Patient Population:
Postop adult patients based upon inclusion and exclusion criteria outlined in the protocol.

Delegation Protocol Champions:
Jon Matsumura, MD – Department of Surgery - Vascular Surgery
Joshua Medow, MD – Department of Surgery - Neurosurgery

Delegation Protocol Reviewer:
Andrea McKenna, MSN, RN, CCNS, PCCN, CNS - Vascular Surgery Progressive Care

Responsible Department:
Department of Nursing and Patient Care Services

Purpose Statement:
To delegate authority from providers to Registered Nurses (RNs) to discontinue radial arterial catheters
in adult patients with IMC or ICU status.

Who May Carry Out This Delegation Protocol:
Registered Nurses (RNs) trained in the use of this delegation protocol.

Guidelines for Implementation:
1. This protocol is initiated when a provider enters an order to maintain arterial catheter with
instructions to discontinue per delegation protocol.
2. Contraindications to this protocol. The radial arterial line will not be removed and the RN will
contact a provider for next steps.
2.1. Intubated patients
2.2. Patients on continuous BiPAP (Bilevel Positive Airway Pressure) or CPAP (continuous positive
airway pressure)
2.3. Patients requiring greater than 6 L oxygen
3. The radial arterial catheter will be removed no sooner than 4 hours post-operative and as soon as
the patient meets the following criteria:
3.1. Patient is weaned from vasoactive drips for a minimum of 4 hours.
3.2. Patient has not received PRN blood pressure medication for a minimum of 2 hours.
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org


3.3. Patient blood pressure and heart rate within notify provider parameters for a minimum of 4
hours (Systolic Blood Pressure 90-140 mmHg, Diastolic Blood Pressure 50-100 mmHg, Heart
Rate 50-110 BPM)
3.4. Patient shows no signs or symptoms of bleeding or complication at surgical site (e.g.
hematoma, stridor, excessive bleeding, high drain output, headache, a decrease in neurological
status).
4. The RN will remove the radial arterial catheter and document per policy 1.11A. Upon removal of the
radial arterial catheter, the RN will discontinue the “Maintain arterial catheter” order in the
electronic medical record.
5. If any of the following occur, the RN will call provider for a decision regarding removal:
5.1. The arterial waveform is not optimal
5.2. The arterial catheter is not functioning
5.3. There is no blood return from the arterial catheter.
6. The radial arterial catheter will be removed if the patient’s hand becomes cold.

Order Mode: Protocol/Policy – Cosign Required

References: NA

Collateral Documents/Tools:
1. Nursing Patient Care Policy and Procedure 1.11A, Arterial Catheter/Insertion, Maintenance, Blood
Drawing, and Discontinuation (Adult) https://uconnect.wisc.edu/policies/clinical/uwhc-
clinical/department-specific/nursing-patient-care/cardiovascular-and-infusion/111a.policy
Approved By:
UWHC Nursing Practice Committee: October 2015
UW Health Center for Clinical Knowledge Management Council: November 2015
UWHC Medical Board: February 2016

Effective Date: February 2016

Scheduled for Review: February 2018

Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
12/2017CCKM@uwhealth.org