PICC line dressing change: am I in trouble? - page 2
by Wheretogo 18,178 Views | 18 Comments
Hi all, I'm new to this site, so please bear with me. I thought I'd ask for some advice or opinions on a situation I encountered involving a PICC dressing change. I'm a fairly new grad working in home health care. It's been... Read More
- 0Mar 23, '12 by WheretogoThat's a good thing to wonder.
Well, with this company, you only get a kit on admission. Otherwise, everything is ordered separately. And since I picked up for a sick all, I was not the one who was supposed to do the ordering, and got there, to find not all my necessary supplies available (when 99% of the time, they are). So I had to "cobble" things together; however, they were all in a bag, in sterile packages.
Side thought: do you think a complex care unit would offer good experience, in comparison to med/surg?
- 0Aug 6, '12 by afraserHey, don't beat yourself up. You thought on your feet in the situation at hand, and came up with a solution. We learn as we go, nobody is perfect, and nobody knows everything. New grads have challenges no matter what area they begin their career in, as do more seasoned nurses. Onward and upward! I'm sure you're taking great care of your patients as you seem very caring and compassionate!
- 2Aug 8, '12 by KelRN215Quote from Susan317In my area, the IV/infusion companies deliver supplies and do basic teaching in the hospital. They do not change dressings/caps, perform infusions, teach in the home or anything of the sort. My company is nursing only and I do all CVL dressing changes and cap changes on all my patients.I'm wondering if you should have changed it all ,doesn't the IV company typically change the dressing. Your job is only to assess the site and inform the IV company of any changes. Unless of course your agency is also a home infusion company?
- 0Aug 18, '12 by paradiseboundRNDon't beat yourself up. If you are worried about, go back ASAP and change it. I've been in home care for 11 years and still have problems at times. Remember you are not in an ideal environment where the supplies are down the hall. Keep a good stash in the car. You'll become a hoarder like the rest of us. Btw, they hire new grads because there is a shortage of hh nurses, at least in my area, and no hospital jobs.
- 2Aug 18, '12 by cathrn64Quote from Susan317Susan317,I'm wondering if you should have changed it all ,doesn't the IV company typically change the dressing. Your job is only to assess the site and inform the IV company of any changes. Unless of course your agency is also a home infusion company?
I have never worked for any company where the IV company did anything other than drop off supplies. They have pharmacist's who do manage the dosing etc, but not anything in the home!
OP, I have run into this situation and the main thing is to make sure the insertion site is covered and secure. I have worked in home care long enough that there were no securement devices. I have always used transparent tape or steri strips (which come in the sterile kit) to secure the PICC if there is no device
- 1Aug 18, '12 by SuesquatchRNI think you are fine, but never ever ever document that there was a lack of anything and that you were therefore required to do something in a less-than-exemplary manner. It's begging the surveyors (those who oversee your agency) to cite you for a deficiency. That was the reason for the frown, not that you made do.
"Dressing changed using sterile technique. Clear occlusive dressing and sterile gauze used to cover." That's it. No discussion about what was NOT available.
And good luck. You'll be fine.