picc line dressing change

[sweetieann]

Just a quick question-- Are routine dressing changes (q 7 days) usually ordered at your facility for your patients, or is this strictly "nursing measure"?

[Reno1978, BSN, RN]

Where I work it's protocol to change the dressing 24h after insertion, then every 7 days, or PRN. No order is needed.

[accessqueen]

The facility where I work, aned most facilities that I know of, have an extensive order sheet for PICC line insertions. It is pre-printed, and Includes the order for the PICC, the CXR, the flushing protocols, AND dressing changes, including use of bio patch. If you are looking for orders directly written by the physician, you won't find them, check in the chart for the type of form I described above in the physician order section.

[sweetieann]

thanks! i also had a question about extension and cap changes (i work in ap sych hospital, so we dotn see all this stuff alot)....who usually does the cap and extension tubing changes? a picc nurse or the floor nurse?

[Tweety, BSN, RN]

Where I work it's protocol to change the dressing 24h after insertion, then every 7 days, or PRN. No order is needed.

It's the same here. It's a standing order, as well as a written protocol.

[Reno1978, BSN, RN]

thanks! i also had a question about extension and cap changes (i work in ap sych hospital, so we dotn see all this stuff alot)....who usually does the cap and extension tubing changes? a picc nurse or the floor nurse?

The floor nurses.

[jnrsmommy]

Agree w/ the above posters. As for the cap changes, they were changed out every week w/ the dressing change, and every time blood was drawn from that port. Extension tubing? Not too sure what you mean on this. If it's tubing for an IV, if it has continous fluid running, then every three days, if not, every 24hrs, I would imagine.

[Christen, ANP]

Same here: PICC dsgs are changed 24 hrs after insertion and then q7 days using sterile technique. Caps are changed q7days or after each blood draw. IV tubing is changed q96 hours / q4days. PICCs must be flushed qshift with saline, or you run the risk of clotting them off. :)

[sweetieann]

thanks for the response! i was wondrign about the extension tubing...like when the picc exists the skin there is a tub that the hub is attached to....does that extension tubing also need changed when the caps are changed?

[Christen, ANP]

nope, that tubing (that goes directly from the skin of the pt to the white hub) is the picc line itself. :)

[Penelope_Pitstop, BSN, RN]

who usually does the cap and extension tubing changes? a picc nurse or the floor nurse?

the van (vascular access nurse) team did it at my last facility. we floor nurses changed everything on non-peripheral central lines, but the van team did the dressing changes and the whole bits for the piccs, because they also performed measurements and kept records of how all the piccs in the hospital were doing.

jess

[iluvivt, BSN, RN]

Nursing generally dictates this practice and most MDS expect that. Most MDS will not be up on what the current standard of care in infusion practice.