PICC Line Protocols

Specialties Infusion

Published

I am a 20 year Critical Care Nurse who has been placed in charge of the IV team. The IV team is composed of very mature RN (25-30+ yrs), but the nurse have basically been doing PIV insertion and care on the Med/surg floors. There are 2 of the 10 nurses on the IV team who are competent/certified for PICC line placement. My facility is changing its goal to have the IV team better "utilized". My delimma is this: First I need train ALL the staff to insert PICC (not a problem have the plan for this) but also develop protocols for placement of PICC Lines. My facility has 5-6% inflitration and 4 % Phlebitis rate, the goal is to reduce these rates by inserting more PICC. Not sure how many PICC were inserted by the IV team in the past, still researching, but If anyone has information or suggestion for PICC line Protocols, I would greatly appreciate it. :uhoh3:

Does anyone have any examples of standing orders for PICC line insertions? I hate to re-invent the wheel!

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I am also looking to improve our policy reguarding picc line tubing change, if anyone has info please email me? thanks

Angela

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I am also looking to improve our policy reguarding picc line tubing change, if anyone has info please email me? thanks

Angela

What do you mean by "PICC line tubing?"

Are you referring to the actual PICC or the IV administration set used with a PICC?

If you are referring to the actual PICC then you need to consult your PICC's IFU, which is published online on the manufacturer's website, and the CDC's guidelines.

If your IFU doesn't mention a time limit, there are none that I am aware of that do, then follow the CDC's guidelines which say if it ain't broke, don't fix it.

CDC - 2011 Guidelines for the Prevention of Intravascular Catheter-Related Infections - HICPAC

Now as far as the IV administration set I would refer you to the 2011 INS Standards of practice. 24 hours for intermittent, 96 hours for continuous, and 4 hours for blood tubing. There are some specifics in there but thats the basics.

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Specializes in Critical Care.

Now as far as the IV administration set I would refer you to the 2011 INS Standards of practice. 24 hours for intermittent, 96 hours for continuous, and 4 hours for blood tubing. There are some specifics in there but thats the basics.

It's important to keep in mind that "intermittent" tubing doesn't actually refer to intermittent tubing. In my experience people typically interpret "intermittent" to refer to tubing for intermittent infusions, ie secondary tubing. For whatever reason, the INS calls secondary tubing not intermittent, but either "primary intermittent" or "secondary continuous" depending on whether it is connected to main set or patient continuously. If it is disconnected at any time it goes from being continuous tubing to intermittent tubing.

Even once you get over the hurdle of understanding their terminology, you should still independently evaluate their rationale and make sure you agree. It's certainly not unheard of for facilities that have done their own decision process on this topic to disagree with the INS on this.

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hi bronzee...i am too searching for picc line protocols. heres my email address can you please forward as well.many thanks for sharing!! [email protected]

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hello...would you mind sharing picc line protocols with me too please. we are in the process of starting to use power picc's. thanks so much. here is my email [email protected]

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INS has a policy book that is pretty good. Also a Standard of Care Book.

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I would very much appreciate PICC protocols if you are still able to share.

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Hi QueenieCRNI,

I work in the NICU and place neo PICCs. Do you have any information that would be useful to me, as well? I just joined Allnurses today, so don't know how to PM, yet. Would you mind telling me how to do it?

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Iluvivt could you send me a copy of you protocol and procedure also. I have been placing PICCs for 8 yrs and did my precasting at OHSU in Portland Or but they do not do that now so I have to train them. What is required for someone to be PICC certified. How many PICCs per year do you need to have to be competent. I work in a small hospital that only does about 100 a year. They want me to train 4 RN's but I am not sure they will be able to feel confident with that few. Please advise. [email protected]

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I work for a facility that is creating a new department that will allow Certified RN's to go bedside and place PICCS/midlines. I am trying to create a work flow for IT and protocol that will allow the doctors to enter ALL orders in the computer, ie. the insertion with Lidocaine, flushing, tip locator vs cxray, maintenance. I happened upon this email and thought you could help me as well.

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