Use of peripheral inserted central catheters ( PICC ) - page 2
Hi In our practice, peripheral inserted central catheter placement is ICU nurse job. We call PICC "our CVC". What`s your expirience ? Do you use PICC in your practice? PICC placement - doctors... Read More
Jan 11, '09Occupation: Clinical Educator Specialty: 25 year(s) of experience in Med-Surg, ICU ; From: US ; Joined: Dec '05; Posts: 15; Likes: 8The PICC's in our hospital are placed only by specially trained RN's, and placement is verified by PCXR. Staff RNs change the dressings per policy q week or as needed.
I work in a CVICU, but some of our long-term patient's will go out to the step-down with PICC'c, and there was where my question regarding frequent blood draws came from, as a nurse from there told me that the RN's out there draw off the PiCC's q 2 hr.s for the patients on insulin gtts. And some of these pat's are on the insulin gtts for days, so i was concerned of the huge blood waste with each draw, and the increased risk of infection with so frequent of interruption.Last edit by tbpmom on Jan 11, '09 : Reason: spelling mistakes
Jan 11, '09Occupation: Clinical Educator Specialty: 25 year(s) of experience in Med-Surg, ICU ; From: US ; Joined: Dec '05; Posts: 15; Likes: 8Also i just read on the Bard Power PICC web site that vamps and CVP monitoring are OK for these lines. I just do not believe that is in the step-down policy though for our facility. Maybe that is something the unit needs to look into as a vamp would certainly be safer for the patient than a constant interruption and frequent,repeated blood wastes.Last edit by tbpmom on Jan 11, '09 : Reason: mistakes
Jan 11, '09Occupation: Currently MSICU Staff/Charge. SRNA in August. Specialty: Critical Care ; From: US ; Joined: Jan '09; Posts: 30; Likes: 10On the question of certification yes. I am one of the PICC nurses at our facility and we are certified by an instructor from the nurse infusion society that was sent to us by BARD. We use the Power PICC and it's ok to use this PICC for a VAMP or CVP monitoring as long as it's a true PICC, you cant use it if it's a midline or mid-axillary line; that will be specified by your PICC nurse after insertion. Don't use the purple power port for CVP as it has a valve in it. Any of the others are fine and there is no distal/proximal/etc... they all terminate at the same point.
On the statement about not normally using VAMPs on the step down unit, I say just go get one from the unit or from central supply along with a pressure bag and use it. You don't have to hook up the transducer to use the VAMP and the comfort to the patient is worth the cost. If you don't normally use them, then have one of the unit nurses help you hook it up for the first time. No big deal, just need to make sure there's no air in the saline bag.
Jan 13, '09From: AZ ; Joined: Jun '07; Posts: 840; Likes: 746Get ready for this:
In my hospital, PICC's are placed by and all maintence is done by RT. Apparently, they have an infection rate of like 3% due to the way they train/implement. Article from when they initiated the program: http://www.azsrc.org/downloads/Airwa...ter%202007.pdfLast edit by Cursed Irishman on Jan 13, '09
Jan 14, '09Occupation: ICU nurse Specialty: Not too many areas I haven't dipped into ; Joined: Sep '06; Posts: 144; Likes: 63We have trained/certified PICC nurses that place our picc lines. We then do all blood draws from that line. We also hook up CVPs (although I have trouble seeing a good waveform with a picc line) and we use vamps for poor insulin gtt pts so they are not poked to death hourly.
Jan 21, '09Occupation: RN Specialty: 3 year(s) of experience in SICU, peds CVICU ; From: US ; Joined: Jul '08; Posts: 216; Likes: 244Quote from Cursed IrishmanThat's... different. I have to be honest, I'd be scared if the RTs at my hospital were caring for my pt's central lines.Get ready for this:
In my hospital, PICC's are placed by and all maintence is done by RT. Apparently, they have an infection rate of like 3% due to the way they train/implement. Article from when they initiated the program: http://www.azsrc.org/downloads/Airwa...ter%202007.pdf
Jan 22, '09Occupation: staff nurse Specialty: 2 year(s) of experience in thoracic, cardiology, ICU ; Joined: Jul '08; Posts: 63; Likes: 70Quote from nursing04Sounds more like they're trying to reduce their central line infection rate to improve their numbers. it's a big issue in ICU's, and I think some insurances and medicare are trying to not reimburse for icu stays related to central line infections.Hello. At the hospital I work for they do not do blood draws through the pts central line whether it be a Picc, portacath, whatever. This is to reduce the risk of infection. To me I would think a pt is more at risk for an infection by being stuck 2-3x a day for blood draws. What is your hospital policy on this? Thanks
we dont place piccs all that often in our icu. we just have 3 and 4 lumen CVL's. if they're going to be going on long term antibiotics then yes, but otherwise it's just easier to have an SC or IJ