Sorry it has taken me so long to get back. Been busy working. I remember from my PICC class(many years ago) that is can be common to have a reaction that can include swelling warmth and redness in the insertion arm in the first 24 to 48 hours after insertion. The recommendation at that time was to observe by measuring bicep every shift and documenting and using ice as needed to help with swelling and discomfort.
We have alot of concerns because we know the nurses on the floor do not even alcohol the caps prior to flushing most of the time and really dont care for the PICC properly after placement but we dont have any concrete proof. We try to document when we get reports from patients that tell us that the nurses dont do this but when we confront and educate they tell us they are doing it and the patient was mistaken or didnt see them do it. Half the time we know they arent even washing their hands when they walk in the room to give care!!!!
At a different hospital my girlfriend (a nurse also) observed the nurses enter and leave the room to get supplies while doing her mothers port dressing change and not even bothering to take their gloves off and put fresh ones on along with not washing their hands. Now talk about spreading germs.
Believe me...we are pushing for 2 to do PICC insertions but keep butting heads with our supervisor. I have gotten alot of information or should I say ammunition from this site!
I will check out the sites you suggested also. Thank you.
As for dressing changes we use a gauze dressing and change in 48 hours. We Chloraprep (which I usually do prior to PICC insertion and again before I apply the dressing just in case I inadvertantly contaminated something). We have asked for the impregnated one but so far havent gotten that either. Some days we feel we are running into a brick wall..literally!