Maximum barriers...argh!

[SWAT_RN]

I understand the push toward maximum barrier use when inserting PICC lines (and other CVADs). Our IC nurse insists that I use a drape that will cover the pt. from head to toe, exposing only the small area needed to insert the PICC. I have been using the Maximum Barrier Kit from Bard, but she doesn't think that's good enough. The gown, gloves, mask (for pt. and me) and cap were being done already.

Also, do you place PICCs at the bedside? If so, how do you deal with traffic in and out of the room? I find it odd that we fixate on draping the entire pt. but allow the procedure to take place in a semi private room and/or have the usual hospital traffic in and out (Oh, sorry I'll only be a minute..etc.).

If you don't place at bedside, where do you place them?

In my perfect world, I have a procedure room with all my supplies and equipment, no interuptions and an extra set of hands...LOL!

[bobnurse]

I understand the push toward maximum barrier use when inserting PICC lines (and other CVADs). Our IC nurse insists that I use a drape that will cover the pt. from head to toe, exposing only the small area needed to insert the PICC. I have been using the Maximum Barrier Kit from Bard, but she doesn't think that's good enough. The gown, gloves, mask (for pt. and me) and cap were being done already.

Also, do you place PICCs at the bedside? If so, how do you deal with traffic in and out of the room? I find it odd that we fixate on draping the entire pt. but allow the procedure to take place in a semi private room and/or have the usual hospital traffic in and out (Oh, sorry I'll only be a minute..etc.).

If you don't place at bedside, where do you place them?

In my perfect world, I have a procedure room with all my supplies and equipment, no interuptions and an extra set of hands...LOL!

At first i thought it was going overboard, but i figure if they want to spend the money on the extra drapes and so forth, then why not. I now kind of like it since it gives me a much larger sterile field. We use a laparotomy drape which is big enough to cover the entire body. I place picc's at the bedside as well using the sonosite US. When placing in a semiprivate room i make everyone leave. If a family member requests to stay, i make them gown, mask, glove, and wear a head cover. I have a sign i made that says procedure in progress that i place on the door for everyone to see.

So like i said earlier, ive grown to enjoy the full body sterile field. I think it benefits the patient.

[SWAT_RN]

Yeah I have that sign too, but still have problems with people coming in. I think I need a shotgun, or a loaded saline syringe...maybe I could shoot all tresspassers on sight...LOL!

[iluvivt, BSN, RN]

I have been placing piccs since 1989. In 2002 our team insisted that we we use Maximum barrier Precautions. Prior to that and to this day we also take other precautions, First we place a sign outside the door stating do not enter sterile procedure in progress, we turn any fans off,(we have fans in almost every room), we pull curtains to minimize air flow and have only essential masked staff in the room. We first place a drape under the selected arm,then place a body drape from chin to foot,then one above and below the site and lastly the fenestrated drape. WOW! Now the all important question......WHY? When can microorganisms be introduded during the insertion and its continued use. Spending a little extra time and $ is worth it to minimize the dreaded CRBSI. Also we have always done a 2-step prep. By the way, try to have some input in the kit or drapes u use. I was suprised when we tried many drapes that I had such a strong preference. Afteandand.r all your hard work make sure the nurses using the lines learn to respect them. We lleave a little instuction cheat sheet on every patient and staple it to the rand. we emphasize cap care anf flushing