Picc team/IV team management/ operations

Asystole RN · Oct 9, 2013

I work in a 250 bed community hospital and our vascular access team in composed of 6 vascular access nurses. We all are based out of ATU (outpatient infusion) and work placing lines 1-2 days a week each with only 1 nurse on at any given time. The idea is that the team can keep a larger pool of skilled nurses on hand at any given time. There is no IV team but we do have a team of SWAT nurses that place unguided PIVs.

mandomania · Jan 28, 2014

Hi. Looks like an older thread but thought I would share my experience in hopes it will help you somehow. I am one of four nurses that provide vascular access services at the 250 bed community hospital where I work. We only do about 50 to 60 piccs a month and I probably do most of those.

It can be challenging when you work in other cost centers, areas, etc. For example, 3 of our PICC RNs work in Cath Lab, and I have ICU and IR background. Lately, I'm doing most of work because our hospital has gutted our budget, and pay has been gutted as well. Here are some thoughts and I hope they help:

1. Recruit people that are dedicated and detail oriented.

2. Have a physician as part of your team, even if its an IR Doctor that can back you guys up. There will be times when some other physicians will try to pressure you into placing lines in bacteremic patients, chronic kidney disease patients, or crumping ***** patients in ED/hospital that just need a central line asap. I mentioned IR docs because they usually hate doing PICCs and by helping your cause, they help themselves. Plus, other MDs will be less likely to be pushy when they know one of their peers backs you up.

3. Look up and keep a copy of articles from National Kidney Foundation, Fistula First, etc. That way you can be a good ambassador for helping other nurses learn why a PICC line isn't always such a good idea.

4. Develope a plan or protocol for placing ultrasound guided peripheral IV. That way you can offer good service..."sorry bud, a PICC isnt the best idea for this patient, but maybe we can place a very reliable IV for him instead". There are some longer IVs in varying guages that are perfect for this.

5. Hours...well, to start, maybe offer a 7am to 3:30pm with a last call at 2pm. Will you cover weekends? If your coworkers carry pagers for other departments, this will be a muy grande headache. Maybe get going for a while and then offer weekend coverage.

6. Charges?....good question. Im sure there are many opinions out there, but I think Bard is an excellent choice. The Sapiens with 3cg is awesome. Bard kits have good quality wires, peel away sheaths, etc. You can pair the sapiens and 3cg w an ultrsound you already have also. I just mention this because I use a different US paired w Bard equip and its awesome. Your bard rep will help you put together a kit for the stuff you want in it. Also, get all of your IV start stuff and figure out your charges.

Well, I sure hope this helps. There are some bright people posting on this site and they are very helpful. Good luck. I just want to mention that you will work a lot with radiology folks. Many managers and people in leadership positions in these areas, ie...IR, Interventional Cardiology, and PICCS, have radiology tech backgrounds. They are awesome people but will view things 100% different than a nurse will. They usually see vascular access as placing device in patient 1234 blah, blah, while nurses see the bigger picture...ie: human component, God, I hope the nursing home doesnt jack up this line,etc. My manager has a masters, but thinks like a tech. It can be very frustrating at times. These are peple, not widgets. Anyway, hope this helps. Im excited for you and wish you the best.