As a Nurse, if I start an IV and give someone a fluid bolus, like a liter of 0.9% NS... I must now document the "end time" of the fluid bolus!
On the surface, this seems like nothing! But if the IV catheter I used to start said IV, happened to be an 18, 16, perhaps a 14 gauge... the fluid bolus might be completed in 20, 10, maybe 5 minutes.
Why is this important?
Well... it seems that my employer won't be payed for care provided by there employees, like IVF boluses now... unless it takes 31 minutes or greater to complete! So I must either slow my IV drip rate to make a bolus run longer, therefore no longer being a "bolus"... or I have to falsify my documentation, saying it took longer than it did! So I am being encouraged to lie!
Likewise...
An IVF bolus can't take longer than an hour to go in, unless I document a reason! Positional IV, small IV catheter, stopped for a procedure, etc...
And...
If I document an IV initiated, but don't document an end time of the IV, even if it is a Saline Lock...the procedure is not billable!?!? I started it, the procedure was done, what's the problem?!?!
Please tell me! Who are making these "rules?"
I can tell you that whoever they are, they have absolutely no concept of medicine, nor of the reality of how medicine works!
And did I tell you, these are Medicare Rules?
Guess I should just shut up and let the government continue its take over...
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