D/C central lines in SNFs?
- 0Feb 11, '10 by nyteshadeHey everyone,
This is really bugging me...Can RNs D/C central lines in the SNF setting? I know it's within the scope of those that have been trained, and I've researched that not every RN can depending on what setting they work in (but this is in regard to the hospital setting). My facility protocol mentions nothing. Help! This is in Florida by the way...
- 1Feb 11, '10 by TheCommuter, ASN, RN Senior ModeratorIt depends on the policies and procedures of the facility in which you are employed, as well as the state BON.
I am in Texas, where RNs always D/C central lines in nursing homes, SNFs, and other LTCFs, as it would not make financial sense to send the patient out to the hospital just to have another RN complete the same task. As long as the RN in the nursing home has undergone training in central line care, then it is permissible to remove it in that same setting.
- 1Feb 11, '10 by pennyalineDo you mean LTAC or SNF? SNFs in my area do not take admissions with central lines. The only temporary long-lines we are able to handle are PICCs. But it's my experience that central lines require CXR after insertion and after removal. If that is still the case, best to just send the resident out to have it done.
- 0Feb 11, '10 by leslie :-DQuote from pennyalinei agree w/you...Do you mean LTAC or SNF? SNFs in my area do not take admissions with central lines. The only temporary long-lines we are able to handle are PICCs. But it's my experience that central lines require CXR after insertion and after removal. If that is still the case, best to just send the resident out to have it done.
in that i've never known a ltc facility to be able to pull any lines other than piv's, mid or picc lines.
at least at a hospital, there's plenty of backup if something goes wrong.
and yes, you need xray to confirm total removal.
- 0Feb 11, '10 by PMFB-RNHere in Wisconsin it is standard for nurses to D/C central lines. It is after all a basic nursing task taught in nursing school. Of course your facility should have a policy and procedure in place and you should follow it. On very small hospital I worked at didn't have policies and procedures for lots of things. They simply made a policy that we follow a particular nursing text book as our policy and procedure guide.
- 2Feb 11, '10 by scoochyCXR after central line d/c'd?? I have been a nurse for 30 years, and it was never routine to obtain a CXR after the central line was removed unless there was a concern re: difficulty with removal.
With regard to the post stating that d/c'ing a central line is a basic nursing task taught in nursing school, I say, wow, I never learned it in nursing school! In the hospitals where I worked, central lines could only be d/c'd by nurses working in critical care settings. IMO, removal of a central line is not a basic nursing task!
I currently work in a LTC facility; PICC lines are only discontinued by the MD or APRN. Every facility is different, and there are state regulations that must be followed to the letter!