Informed Consent/ Authorization for PICC Placement

[IVT-G]

Our institution here in TMH has declared that a informed consent/ authorization was not needed when a PICC is placed by the RN's. We have been obtaining authorizations since the we started placing PICC over 25 years ago. Of all the institutions that do place PICC by nursing, what current practice does your institution follow. Thanks. fb

[mopnglo42]

We had the same issue at our hospital when we changed radiology groups. Here, the nurses aren't actually the ones who put in the PICC lines, it's the radiologists. We were told that a consent wasn't needed because it was covered under the general consent when the patient is admitted to the hospital.

[Gail-Anne]

We require consents and I can't see that ever changing. Basic consent to be treated in hospital is fine for the basics (like a peripheral IV) not for invasive proceedures. What do the risk management folks at your institution have to say about this?

[mopnglo42]

We have a Professional Practice Council, which I sit as Co-Chair. It's the council that edits and reviews policies and procedures using evidenced based practice. It was brought to the council, because we (the nurses) felt we needed a consent due to the fact that it is an invasive procedure. But the hospital attny and the other head honchos said that no, it was covered under the general consent. They said that it fell under the same lines of having, for example, a chest tube placed. It's invasive, but no consent is needed.

[cbc nurse]

In the Hospital where I work in Uk all PICCs and central line placements have written informed consent prior to procedure. Initially it was only nurses placing who obtained consent, but now any doctors who place must also get consent. Sometimes they follow our lead!!

[deestink]

i work at an outpatient infusion center where we also place picc lines in the clinic and hospital setting and was just informed by our nurse executor not to obtain a written consent for the insertion of the picc line she says yhere is no need for this and compared it to putting in a ng tube i am trying to find out some data on this topic my colleagues and i are very uncomfortable with this and would like to know how that leaves us nurses vulnerable any info on this would be greatly appreciatedthank youdolores tinker rnkaiser hospital ca

[PICC ACE]

From the 2006 INS Standards of Practice "The nurse shall verify that the patient's informed consent was obtained,and shall document the information given and the patient's or legally authorized representative's response in the patient's permanent record....The patient or legally authorized representative shall be informed of potential benefits as well as complications associated with treatment or therapy." Pretty straight forward,and these are the nationally accepted legal standards of practice. Don't confuse "obtaining consent" with getting a form signed. The process is what counts. Do you fully explain the procedure to the patient? Do you make sure the patient knows the benefits and risks of PICC placement? The benefits and risks of refusal? And is this all done in a way the patient can understand? If JCAHO scrutinizes your PICC program,they will want to know the PROCESS you implement to obtain consent from your PICC patient,not just that you have a form or signature.