PICC Line Protocols

[sdixon22]

I am a 20 year Critical Care Nurse who has been placed in charge of the IV team. The IV team is composed of very mature RN (25-30+ yrs), but the nurse have basically been doing PIV insertion and care on the Med/surg floors. There are 2 of the 10 nurses on the IV team who are competent/certified for PICC line placement. My facility is changing its goal to have the IV team better "utilized". My delimma is this: First I need train ALL the staff to insert PICC (not a problem have the plan for this) but also develop protocols for placement of PICC Lines. My facility has 5-6% inflitration and 4 % Phlebitis rate, the goal is to reduce these rates by inserting more PICC. Not sure how many PICC were inserted by the IV team in the past, still researching, but If anyone has information or suggestion for PICC line Protocols, I would greatly appreciate it.

[QueenieCRNI]

OneandonlyPICCRN: we are in the same boat! tell me where your challenges are and I can maybe help you here before we begin to communicate separately.

[wonandonlyPICCRN]

QueenieCRNI, where do I begin???? Presently, we only have a policy for PICC insertions. I would like to have guidelines/standards of practice spelled out for the part time PICCers who relief me when I'm not here so that we all follow the same "rules" and the PICC Team remains consistent. I am very interested in what other facilities do and what kind of guidelines/policies are followed. I hope our communications are counting toward our requirement of 15 posts...I'll be writing you every day! Thanks for your time!

[iluvivt, BSN, RN]

if you PM with your E mail I can send some samples ..just remember that insertion is only the beginning..the battle is in line and site maintenance and getting all nurses that use the line to scrub the cap and have respect for the line. I just re-wrote all of ours to make certain they were all in line with the NPSGs and their emphasis on maximal barrier precautions..standardized cap care...etc

[omar hawamdeh]

I see lots of requests for PICC and IV protocol. I am at a very large hospital with a very large and busy Venous Access Team, we place 500 PICC's a month. I am willing to share and help. Send me a PM and I will do what I can! The more info you have the better!

hi every one:

i'm a staff nurse in a general hopital looking toward to has an oncology heamatology wards and I was assigned with other collegeus to establish protocols and policies to be applied and teachable to the others.( we are talking about cytotoxic safehandling, administration, extravasation policy and procedure, guidelines about dealing with periphiral or central lines, also the oncology nurse gudlines in chemotherapy area)

please if any one has some to send me

regards.

[wonandonlyPICCRN]

iluvivt,

Not able to send PMs as of yet due to few posts. Would love to get samples from you when I get my quota of posts. Thanks for your willingness to help out.

WonandonlyPICCRN

[QueenieCRNI]

WonandonlyPICC RN:

The policies you write should pertain to all who work. I think what you are looking for are other guidelines about your particular practice in your facility that do not lend to policy statements. What we did was, each time I post a clarification to a policy or unusual situation, I put it in a notebook for all to sign. This helps me too as the clin spec, to track who is reading and not. YOu can never cover every eventuality in a policy so clarifications are good and posting is easy to find.

Look in your journals, INS textbook, INS policies and procedures book and standards. Use CDC as well and AVA position statements. Decide what is the comfort level of your facility, as all these sources do not agree, unfortunately, but there is a pecking order!

Get your manager, or whoever your upper leadership is to sign off as well, that covers everyone!

Keep em coming!!

QueenieCRNI

[GLORIA DEVIA RN]

I would love to have a copy of your PICC protocol. Gloria

[Msfixitrn]

IF you could share your protocols that would be great. Working on getting a team ina new facility and can use all the help I can get!

[cseals]

I too have experience in this field. I love the work and am looking to possibly start my own outsource company. Does anyone know the saturation in the Los Angeles county region in California? How difficult are the laws to obtain a business license to do this work? I am new to the legalities where this concerned but am product and skill knowledgeable. Any insight from anyone would be awesome!

Thanks in advance for your comments.

[alicecen]

Hi all,

Just some thoughts on good places to get protocols, polices & procedures. In previous positions I've held I have had to write IV and PICC P&P and found great resources that I often suggest to clients (in addition to great colleagues as are sharing in this arena):

The iv therapy site (formerly the IV list serve) has a section full of policies and procedure samples and multiple other resources that are continuously updated by members. The site is: http://iv-therapy.net .

The Infusion Nurses Society has a Policy and Procedures for Infusion Nursing book for sale via their website. They also have a Competencies Validation Bundle that includes the Policies and Procedures Book and their Clinical Competencies Program on CD ROM. Some of the poilicies in the book tend to be very generalized - but they help to get a base P&P to get started: http://www.ins1.org or direct link to the online store: http://www.ins1.org/i4a/ams/amsstore/category.cfm?category_id=7

Also, iv-therapy.net resources section includes updated links to many of the regulatory and infusion/vascular access industry organizations guidelines, standards, and recommendations such as the CDC, JC, IHI, etc.

The new INS Standards of Practice due out in January, will have us all updating our programs soon.:)

[irmaniurka]

i am home health nurse ,,, i had order for Iv meds , trought picc line , one lumen ,,,,pharmacy sent to home , heparin syringes and normal saline,,,,i would like to refresh protocol, before and after medication , and how often do i have to change dressing...thanks ,,,

[CRNI(R)]

The Infusion Nurse Society (ins1.org) sets the global standards for excellence in infusion nursing. If you use their information you cannot go wrong.