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Laws in different states

I live in California. In all the facilities we've been to so far in the first semester of nursing school, a nurse has to have a co-signer for insulin and heparin, so I believe it is a state law, but I am not sure. 

I was in the ICU today and was following a traveling nurse from Arkansas. She was giving heparin to a patient and said "Heparin doesn't need to be co-signed," and just gave it. 

So I'm assuming other states don't require a co-signer for heparin? What about insulin? I am just curious about it now. 


( 10 comments — Leave a comment )
Apr. 24th, 2012 01:52 am (UTC)
Georgia does not require a co-signer for anything a nurse is legally allowed to give. Though it is a good practice to have another nurse double check drugs that can screw you if you make even a minor error.
Apr. 24th, 2012 04:24 am (UTC)
As far as I'm aware New York doesn't require co-signers either.
Apr. 24th, 2012 02:36 pm (UTC)
If we hang a heparin drip or insulin drip, then yes, it needs a witness, but as far as SQ heparin or insulin? No, we'd be spending all day witnessing since almost all of our patients are on some type of DVT prophylaxis, and SQ insulin. i'm in Florida...in the ICU.
Apr. 24th, 2012 06:16 pm (UTC)
same in Ohio.
Apr. 24th, 2012 11:21 pm (UTC)
Also, I don't know if the consigner is state law or hospital policy.
Apr. 24th, 2012 11:48 pm (UTC)
I've seen them do it at the facility I work at, another nursing home, and three hospitals
Apr. 24th, 2012 03:05 pm (UTC)
In Michigan you do not require a co-signer for heparin SQ or IV. That is interesting that CA does.
Apr. 25th, 2012 03:24 pm (UTC)
TPN, all insulin (just SQ on my floor), and Heparin drips require a co-signer where I work in MD. It's a huge hassle, and I honestly don't believe that it makes these medications any safer on my floor.
Apr. 26th, 2012 01:21 am (UTC)
It could be a facility requirement. I know that at my hospital in FL, subq insulin did require a cosigner at one point. The situation came to a head when the hospital introduced EMRs and computerized MARs...it became such an issue that, after much complaining over the first month of the computer roll-out, the hospital cancelled that requirement.

When working as an RN in central PA, we never had such a requirement. Neither state/facility had a cosign requirement for subq heparin, either. But I've always had cosigners for PCA pumps, heparin drips, and IV insulin boluses (I've never given an insulin drip as I'm not in the ICU).
Apr. 26th, 2012 01:54 am (UTC)
I don't think it's a facility req, just because I see it where I work and at a few facilities we've been too, and none of the facilities are connected
( 10 comments — Leave a comment )


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