Hello, everyone.

First time posting here - searched the board, but no luck. If I've overlooked a post, please redirect me and remove this one.

My hospital, part of a larger health system, is undergoing conversion to interoperability between our large volume IV pumps and our EHR (Epic). I am curious if any sites currently have in use a protocol to provide nursing the ability to reduce infusion rates for IVPB's known to cause vein irritation (potassium chloride, vancomycin possibly, etc.) by perhaps 50%.

For context, we run KCl 10 mEq over 60 minutes. If a patient expresses discomfort with the infusion, nursing is in most cases going to reduce the rate to avoid discomfort (prior to interop). However, especially now with interoperability, we would like to have this in writing as a protocol (and described as permissible in policy).

If there is any resonance to this at your institution, could I also ask: are nurses re-entering the order for the new rate (i.e. KCl 10 mEq over 120 minutes), or just documenting the different times on the MAR (I assume that's pretty messy)? I see some issues here with "K Runs" where 10 mEq is given hourly x 4 doses for example (where only peripheral access is available).

Very much appreciate any insight!