maciv

Any time you place a Picc and it dwells within the lower third of the SVC,despite readjustment, is successful.

On our IV/Picc team we do not have a cutoff,it depends more on the pt's anatomy and can we place it with one stick,the bleeding can be controlled at the insertion siteand sometimes the INR can not be reversed,doing so would put the pt at risk.It really is a judgement call on the nurses part after careful assessment of the pt's whole clinical picture.

I agree with cupcake,your critical care background will serve you well,as the pt has to be assessed as to wether they actually need the line or not.Also you may be the initial first person on the spot, due to the fact that IV Nurses function with a great deal of autonomy troughout the hospital,and you already posses IV insertion skills to build upon.

Hi all,new to this great forum,in my facility,amajor urban medical center the MD's do not order the Picc lines,they consult the IV/Picc nurses via computer,we in turn evaluate/assess the pt The medical center,nursing service,infectious disease and Legal have allcollaberated with us, the IV/Picc nurses to develop criteria for the placement of Picc lines.I have been placing Picc lines for ten yrs and for the longest time[about six yrs] the MD's obtained the consent and they always had a problem with doing so,as they felt the were consulting us to collaborate and the final decision to place the line was our decision.The consent is a template in the computer and consists of a many part discussion that we have with the patient that covers the RISKS and BENEFITS,OPTIONS,ADVANTAGES AND DISADVANTAGES.The fact that I obtain the consent may have much to do with the fact that I work in a Federal Facility,however our Nursing Administration had many hours of communication with the state BON.It's my practice and responsibility.