PICC Lines in Radiology - page 2

by angiorn

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Are any radiology RN's placing Picc lines in their departments and if so are you utilizing fluoro or ultrasound guidance? In the instance that you are using fluoro, is it a technologist administering the radiation? What... Read More


  1. 0
    Hi - im a radiology specialist nurse in Leicester, UK.

    I am trained to place picc/Hickman lines under U/S and Fluro tend to place more Hickman lines into the subclavian than PICCS

    I also report and verify tip placement myself.

    Hi by the way - new to the site, hope to become involved actively in various threads.

    Sharon
  2. 0
    Very interesting thread as I am currently in training for PICC placement...thanks to all for the excellant information!!
  3. 0
    Tell me about your position. What hours and days do you work, who is your back-up, how are patients referred to you and by whom, how big is your hospital? We are discussing a PICC nurse to place piccs with US or flouroscopy as needed. How many do you place, say, a week. Who is your boss?
    Last edit by nurhmb on Nov 4, '04 : Reason: The thought did not thread as I wanted it to
  4. 0
    Quote from nurhmb
    Tell me about your position. What hours and days do you work, who is your back-up, how are patients referred to you and by whom, how big is your hospital? We are discussing a PICC nurse to place piccs with US or flouroscopy as needed. How many do you place, say, a week. Who is your boss?
    I am a full-time PICC nurse, I place all my PICC's at the bedside using u/s. I average about 70-80 successful placements a month. Very few I am not successful at. I work Monday-Friday. I get here around 0730 and stay until all my PICC's are done. I also help with difficult IV sticks, perform dressing changes, keep in touch with all my patients that have been discharged with their PICC or had it placed as an outpatients. I do call every other weekend. Have back up for the other weekend and any time off I may need.
    I report to the CNO of the hospital. I hope this gives you a little more info on what your looking for.
  5. 0
    We are in the process of beefing up our PICC abilities hospital-wide. Right now there are a few nurses, hospital certified, who are placing the PICCs at the bedside, confirmed by STAT port CXR with a wet read. If we cannot get it in after two tries, then the patient is sent to radiology and the radiologist/nurse team place it under fluoro. One of our biggest problems right now is educating physicians on appropriately ordering PICCs. If a nurse calls him on a Friday afternoon with the fact that a patient is a "difficult stick"and they havn't been able to give Abtx or draw blood, to avoid being called over the weekend, the MD will order a PICC line. Never mind that it may not really be necessary if a a good IV nurse could get the line in to begin with. We have to IV team here. Any suggestions here?
  6. 0
    Quote from cab631
    We are in the process of beefing up our PICC abilities hospital-wide. Right now there are a few nurses, hospital certified, who are placing the PICCs at the bedside, confirmed by STAT port CXR with a wet read. If we cannot get it in after two tries, then the patient is sent to radiology and the radiologist/nurse team place it under fluoro. One of our biggest problems right now is educating physicians on appropriately ordering PICCs. If a nurse calls him on a Friday afternoon with the fact that a patient is a "difficult stick"and they havn't been able to give Abtx or draw blood, to avoid being called over the weekend, the MD will order a PICC line. Never mind that it may not really be necessary if a a good IV nurse could get the line in to begin with. We have to IV team here. Any suggestions here?
    The Friday afternoon PICC seems to be a common problem. Unless you have a 24/7 team, someone has to hang into Friday night etc. We are looking at admission criteria (Atlas Computer Program) that might ID patients who should have PICC from day 1 because we know that they will have prolonged IV's...osteos and such .....in order to id some of these people earlier in the admission and the week. I don't know if we would then approach the MD for the order or if there would be some kind of automatic ok obtained from the physicians so it was could be initiated by protocol. We are trying to figure out how a smaller hospital maintains more than one position and back-up for PICC insertions and what "the rules" need to be on this to be the most effective for patients but also the PICC nurse. Physician education is a huge issue. I have made a joke that one of the critieria for a PICC should be the physician does not want any pages. If we put that as number one, we would get everyone on the day of admission.
  7. 0
    Quote from cab631
    We are in the process of beefing up our PICC abilities hospital-wide. Right now there are a few nurses, hospital certified, who are placing the PICCs at the bedside, confirmed by STAT port CXR with a wet read. If we cannot get it in after two tries, then the patient is sent to radiology and the radiologist/nurse team place it under fluoro. One of our biggest problems right now is educating physicians on appropriately ordering PICCs. If a nurse calls him on a Friday afternoon with the fact that a patient is a "difficult stick"and they havn't been able to give Abtx or draw blood, to avoid being called over the weekend, the MD will order a PICC line. Never mind that it may not really be necessary if a a good IV nurse could get the line in to begin with. We have to IV team here. Any suggestions here?
    It took a lot of training and support from my CNO to make the Doc's and the staff aware that PICC's are not done after 5pm. Granted that by 4:00pm I may still have 3 picc's to do, and I stay to do them. Anything after 5:00 gets placed the next day. PICC's are not an emergency! If the patient is doing that badly then a central line should be placed.
    Case Management is a good way to capture pts that are going to be dc'd with a PICC as they are the ones that are setting up home health. It is appropriate for the PICC nurse to say that this person can get by with a peripheral. I ask the staff here to call me first for difficult IV sticks before they call the MD, because he will surely order a PICC.
    It is a difficult job to get staff and docs to be proactive instead of reactive when it comes to IV therapy!
  8. 0
    Quote from PICC chic
    It took a lot of training and support from my CNO to make the Doc's and the staff aware that PICC's are not done after 5pm. Granted that by 4:00pm I may still have 3 picc's to do, and I stay to do them. Anything after 5:00 gets placed the next day. PICC's are not an emergency! If the patient is doing that badly then a central line should be placed.
    Case Management is a good way to capture pts that are going to be dc'd with a PICC as they are the ones that are setting up home health. It is appropriate for the PICC nurse to say that this person can get by with a peripheral. I ask the staff here to call me first for difficult IV sticks before they call the MD, because he will surely order a PICC.
    It is a difficult job to get staff and docs to be proactive instead of reactive when it comes to IV therapy!
    I agree that a PICC is not an emergency intervention. I am assuming that you do not do PICCs on weekends. What are your Mondays like? How big is your hospital? Are you doing the 24 hour and regular dressing changes consistantly? Who handles the Friday patients dressing management? What would you do differently if you started the program again? Your insights are helpful. Thanks.
  9. 0
    The census runs around 200, we do provide on-call weekend coverage but not for after hours. When I took this position, one of the first things I did was provide classes for the nurses on care and maintanence of PICC lines. I do try and keep up with the dressings, but some days I'm so busy inserting I don't have the time. Most to nurses are pretty good at getting them done if I don't.
    I also assist with difficult IV starts, I also do a fair number of PICC's on out-patients, which acutally makes money for the hospital. Reimbersument is quite good. I track all blood cultures and central line infections and the dwell time of all PICC's, it the patient has completed therapy without complications or if it was removed due to complications. Which means that I make telephone contact with all patients who have been discharged either home or to a LTAC.
    I compile the data into a quarterly report which administration loves! I look at it as good job security!
  10. 0
    Quote from PICC chic
    The census runs around 200, we do provide on-call weekend coverage but not for after hours. When I took this position, one of the first things I did was provide classes for the nurses on care and maintanence of PICC lines. I do try and keep up with the dressings, but some days I'm so busy inserting I don't have the time. Most to nurses are pretty good at getting them done if I don't.
    I also assist with difficult IV starts, I also do a fair number of PICC's on out-patients, which acutally makes money for the hospital. Reimbersument is quite good. I track all blood cultures and central line infections and the dwell time of all PICC's, it the patient has completed therapy without complications or if it was removed due to complications. Which means that I make telephone contact with all patients who have been discharged either home or to a LTAC.
    I compile the data into a quarterly report which administration loves! I look at it as good job security!
    Are you just involved with PICC stats or do you also get involved with other central line stats? How many outpatient PICCs do you see, say, in a month (just curious). Your job sounds sort of like what we had visualized might be a full time position. Who does your back-up? You sound almost like a modified IV team of one. Your hospital is lucky to have someone like you with your skills who likes what she is doing. Your feedback is very helpful. Thanks.


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