D/C central lines in SNFs?

[nyteshade]

Hey everyone,

This is really bugging me...Can RNs D/C central lines in the SNF setting? I know it's within the scope of those that have been trained, and I've researched that not every RN can depending on what setting they work in (but this is in regard to the hospital setting). My facility protocol mentions nothing. Help! This is in Florida by the way...

[netglow, ASN, RN]

Its a stupid policy and I sincerely doubt that they are doing it so the "residents can learn it." All the residents I know hate being paged for central line removals, its not some big complicated procedure and its ridiculous that only an MD would be allowed to do it. Its clearly within the scope of ability for a regular floor RN to do.

Central line removals are not like intubations where you need a lot of practice to get it right. I can do a 5 minute demo on it to anybody willing to learn, and unless they are an absolute fool, they will have no problems mastering it without being supervised again.

But you guys have to do some sort of scut... we do most everything as RNs, so in a teaching hospital some stuff must be left for you to do as residents.... doesn't really matter what, gotta keep giving you reasons to continuously see/do for patients, unless you plan on being an internist. :sofahider

[ponytailman]

As a iv certified lpn working a snf or rehab or transitional unit (name of the week)i am allowed to remove all non surgically placed iv lines, this means piccs,midlines and peripherals. At our facility cxr are done for picc insertion only, if the central line was surgically implanted then either the arnp or md has to

[leslie :-D]

P.S. Inserting a foley cath is a much more dangerous/complicated process than removing a central line, yet putting in a foley is not something that MDs are required to do.

why do you think foley insertion is more dangerous and complicated?

what's the worst that could happen?

but pulling a cvc could be dangerous, i.e., air embolism.

nothing of the sort will happen w/foleys...

unless i'm having a brain freeze....again.:)

leslie

[nyteshade, BSN]

Well, thanks everyone for your input.

[caliotter3]

The only time this was ever done in a SNF where I worked, the doctor came in to the facility to DC the line. They said that the resident was not moved to the hospital because the doctor did not have admitting privileges there. BTW, in a previous life, that particular doctor had been an RN.

[CoffeeRTC, BSN, RN]

We do them in PA. Now most of our IVs are Picc or midline and occasionally a peripheral. Its been a while since we've had a good old central line. I believe we have a P and P inplace too.