Quote from hkirk1466
The home health nurse is doing the dressing changes but they give us a hard time when we ask for more than one at a week. The paper the hospital gave us says twice a week. They wont let me, because I "wont use sterile procedures" But the home health nurse will rummage aroun in her purse with sterile gloves on. The Dr just said change the bandage more often. The picc line is on an 8 year old boy so it is hard to keep still.
Well as an specialist in Infusion Therapy, I can understand your concern. The "norm" is to change the dressing covering a PICC line q 7 days and prn (As necessary), but some institutions do do it more frequently. You are right in saying that it is hard to keep an 8 year old boy still, and the dressing clean, dry and intact, but attention needs to be paid to the dressing frequently to ascertain that it remains intact. Depending on the size of your 8 y/o, covering the arm work well to keep it from getting pulled on. There are commercially designed products that will aid in this, but I've also seen great success with large mens tube socks (not used of course) but straight out of the package, and the foot cut off. That way, the tube slips right over the arm and the dressing therefore stays intact. Great care should be taken when this tube is removed, however, to prevent the catheter from getting pulled on. (The tube should NOT be tight fitting around the arm, but rather provide a good covering) Also, it is important to protect the catheter/drsg so it does not get wet in the bathing process.
As far as the nurse going into her purse "during" the sterile procedure, I pray that it isn't being done "during", but after the dressing change was completed. Otherwise you have a break in sterile technique, and new sterile gloves needed to be donned, but only after alcohol hand gel was used and your hands were rubbed dry.
Talk to the HH nurse about your concerns, or the Director of the home health agency. Perhaps a site visit needs to be done by the DON and nurse to assess competencies. Competencies should be done at least yearly by the head of the agency to ascertain that everyone is "still on the same page" with practice criteria.
Hope this helps.