consents for picc insertion

[thomas76]

Our institution at one point felt it wasn't necessary to get consents for PICC insertions because we did so many, and now it became necessary again due to legal reasons. Since its an invasive procedure it makes sense to get informed consents, but it becomes an issue when the patient cannot sign and there is no family. I think it delays the treatment process. What do other facilities do? Do you get consents and what is done when there is no family?

[MunoRN, RN]

You always need consent to insert a PICC line (or start an IV, give a med, etc), regardless of whether or not you need written consent.

If the patient is incapacitated and there is no one available who can consent on their behalf, the patient is usually consented on the basis of medical necessity.

[thomas76]

Yes I was talking about written consents. Medical necessity is also done but it has to be like a life and death situation.

[HMarie13]

We have a specific written consent for when I (PICC nurse) or radiology places a PICC. When we have a patient that cannot sign for themselves we first contact family. Usually we do telephone consent with family and have 2 RN's speak to them to verify it is ok for placement. That way we don't wait around all day for someone to actually be at the hospital.

When we have a patient with absolutely NO family/power of attorney, we have the physician sign the consent for medical necessity.

[Asystole RN]

Check your state laws, they should have something that gives precedence.

At all of my vascular access jobs if the patient cannot sign and there is no POA then we have policies (this is the same for 3 different companies in 3 very different settings) that we get two LIPs to sign off that it is medically necessary. Usually the PCP/hospitalist and the specialist.

Informed consent does not mean a piece of paper. I would highly recommend you google the legal term informed consent and read the legal cases that formed the defininition.