PICC nurses...do you read your own tips

Hope this is not too late for you. In California nurses that are trained and certified by the procedure set up at their place of employment can verify the course of the PICC line including the tip location. We must set it up as a standardized procedure with annual re-certification (usually a quick test).
If there is any question or doubt about the PICC tip we can re-order a second CXR or send it to a virtual radiologist as it would be unwise to release if not well seen. We do not have a time frame for rad to look at it,though generally it is read within 2-14 hours,depending on the time it was taken. We do not have radiologist past 1730,unless they are called in for a special procedure. We do reconcile our read with theirs to make sure all is OK and make adjustments accordingly.

Hi, We currently do not officially read our picc tip xrays and really do not want that responsibility. We can view them on the computer, but the radiologist is responsible for the results. Our problem is getting them read

Just wanted to let you know one more thing before you go to your meeting. You need to check with the Board of Registered Nurses in your state. They will determine what you can and cannot do. Most states have a decision tree on the functions that are gray in nursing. These are areas where nursing and medicine overlap. As far as the radiologist not wanting to read the PICC location AT ALL....quess what....they do not have a choice. That CXR must be read and comments on all things seen in that film must be commented on. What about team work here...thats what you need to tell them. Please remember that if there is a film in which you are unsure about where the tip is you do not read it and let the radiologist to it. I would be happy to send you or E-mail you a copy of our standardized procedure. send private message if interested

Also what about incidental findngs, pneumo, nodules, ect.. the x-ray should get a final read for liability reasons. It would be a huge problem is cxr was done for tip localizaton but no read and mised lytic lesions in the ribs and you have this wondeful image that will go to court.

Now if the RN is only confirming tip location prior to use and the x-ray is also read and dictated appropriatly the RN should be able to start use of the PICC prior to final reading.

Jeremy

I always go down to x-ray and read the tip placement with the radiologist. Then if it is malpostioned we can discuss options and I also know what he is looking at. It really helps alot. We have to take a course to be able to read our own tips. But it would be nice to be able to start therapy and not wait. After all I can see if it goes up into IJ or down into SVC and have learned enough standing beside the radiologists to know approximately where my landmarks are and if I am in atrium or lower SVC, but I still would want a radiologist to back it up because even they have been wrong on occasion!