Quote from MunoRN
I'm curious how this works with outpatients, do they have to have placement verified for every visit for a dose of antibiotics?
When we admit a patient to our service, we require verification of catheter tip placement, which is usually just a copy of the transcript from the bedside x ray at the time of placement. At each subsequent visit, catheter patency is assessed (can you get blood return, does the line flush briskly, has the external length changed, is the patient reporting any symptoms a/w tip displacement, etc). At the end of service typically 6-8 weeks later, the PICC line is pulled and the patient discharged from our service.
For ports and tunneled lines, we typically maintain those over an extended period of time, so assessments are done regularly, and appropriate action taken for any concerning findings, whether it be tPA, an x ray, or a dye study. The patient is still on our service for port/line maintenance.
Why would the concern for line displacement be any different due to whether or not they are coded as an outpatient or inpatient?
It's not, really. It's more that there is an interruption in service. In the outpatient setting, if a patient were discharged from our service and readmitted at a later date with the same line in place, we would require confirmation of tip placement to rule out displacement in the interim, when the patient was not on our service receiving regular assessments from us.
Think of it this way; in the hospital, you don't get a chest xray to confirm placement before every use, but rather, only at the start of service. Each separate admission is a separate episode of service. Same in the outpatient setting.