[bobnurse]

We had corporate come in for a mock survey and a "mock" surveyor said that nurses cannot obtain PICC line or any type of consent. Only physicians. We told her she was wrong, and it was basically she's right and everyone else is wrong. So now we have to prove that nurses can indeed obtain PICC Line consents.

In the Bard PICC Course manual it states that nurses can obtain PICC Consents, since they are the one providing the education and will go to court over the PICC Line.

I need more evidence in writing to back this up. Anyone have some info, link, or proof that nurses can obtain PICC Consents. Our nurse practice act does not reference consents and its usually left up to the facilities p & p.

Thanks for your input.

[CritterLover]

Sorry, I agree with the mock surveyor.

It is never a nurse's responsibility to obtain consent.

"Obtaining consent" implies informed consent. "Informed consent" means that the patient has been educated regarding risks/beneifits of the procedure.

Only a physician can give risks/benefits conseling. This is not something that can be delegated. This is not only a state regulation in most states -- including the one I practice in -- but it is also a CMS regulation.

Where consents are concerned, the nurse's responsibility is to witness the consent, and to check with the patient if there is any other info they need before signing.

It doesn't matter that the PICC is being placed by a nurse. It it still ordered by the physician, and it is the physician's responsibility to do the risk/benefit education.

The facility I worked at got "around" this (since we all know that a doc isn't going to come in and give that risk/benefit education, even if they knew what the risks/benefits of a picc were ), by having one of the interventional radiologists create a "risk/benefit" education hand-out. Hospital Legal decided that this was good enough to stand in for the physician-provided risks/benefits counseling. So, once the patient/family reads this, they are able to sign the consent and the nurse can wittness it. (By the way, we [the picc nurses] were not allowed to wittness the consents; it had to be the bedside nurse).

The regulations do not say that only a physician can educate about the procedure, only that the risks/benefits counseling must come from a physician. So it is fine for the nurse to answer additional quesitons. However, there were times that I had to refer some patients that had very specific quesitons they wanted answered prior to picc placement, back to their physician before I placed the picc.

[Kymmi]

I agree with critterlover.....in our facility MD's must provide the education and obtain the consent even though it is being placed by a nurse.