sorlando

What does your hospital require after a Picc line adjustment? Do you always have to get a repeat cxr? We just started a new picc program at our hospital. When we recieved training we were taught that you can pull back up to 3 cm without getting a repeat cxr. Today we put in a picc and it was too deep so we pulled back 2 cm. The radiologist read the x-ray about an hour later and had a fit that we let the patient go without a repeat cxr. I'm wondering if there is some lititure or guidlelines that would apply to this situation.

I work at a small hospital and we will be doing piccs for everybody ( ICU, other inpatient, outpatient and oncology). I wanted to pick something that would work universally for all our patients but after reading your comments I guess that is not realistic.

We are starting a picc program at out hospital and trying to decide what type/brand of picc to use. They will be used on inpatients and outpatients. I am looking at the Bard power picc and the Bard solo. The hospital I recieved training from uses the Bard power picc exclusively, but I don't like the idea of having to flush q12 hours. I am leaning toward the solo just because the required frequency of flush is one week and this would be much more convenient for our outpatients. I would appreciate any feedback on the brand/ type of picc you use and any pros or cons you have seen. Thanks!

If my facility does not have any statlocks at time of dressing change, is there something that could be used instead?

This could be a venous stasis ulcer, your description of bronze brown color sounds like some venous insufficiency. If you have weeping there has to be some openings in the skin so I would call it a wound.

Thanks for the advice. We are using PICCs right now. The patients we have either come to us with them or have to drive 45 to 75 miles away to get them inserted. My estimation of 2 or 3 a month is based on about how many patients we see right now with PICCs. I think your comment "if you build it they will come" may be right. This may be something our hospital would use more if it is readily available.

I have felt like this before and decided that I needed a change. I transfered to a department of the hospital that was lower stress and a few less hours each week. It was a hard decision to make because I loved the area I was in before, but after I made the switch I knew that is was the right decision to make. My family life is so much happier now and that's what really matters.

Sounds like some people have some anger issues. This poor guy that is calling him just doesn't realize his boundries. I have had this situation happen to me and I just nicely explained to the patient that it would be better if he didn't call me at home, end of story. He doesn't call me at home anymore and there are no hard feelings because I was nice and professional about it.

I work in an outpatient department at a small rural hospital (about 70 bed). We do outpatient infusions along with a variety of other procedures. Our director would like to send two nurses to get training to insert PICC lines. The training would be an online course and a hands on class that lasts one or two days. I am considering doing this but I am worried about a couple things. First of all I am wondering if this is enough training to become proficient at inserting PICCs on our own. Right now there is no one at our hospital that has any experience inserting, so after the training we would be completely on our own. Second I am worried that we would not have the volume of patients to stay proficient at inserting. In my estimation we might have 2 or 3 patients a month that would need a PICC. Can anyone with some experience in this area help me out with some advice? I would like to do this but I don't know how hard it is and how much practice it takes to get good at it.

I work in an outpatient department and we have been doing this for about a year. It's for medicare reimbursement.

The hospital I work in is an 'at will' employer. They can fire anyone for any reason. Maybe this hospital that this nurse is working at is the same.

You could try using the Duoderm signal by itself. I don't know if you have Mepilex. I would use Mepilex AG on this type of wound.

Do not show up at 8:30am for your 10:00am appointment and then glare at the nurses walking by because you are waiting so long! Do not show up at 12:20pm for your 10:00am appointment and then get mad because you have to wait so long! Why do people not understand the meaning of APPOINTMENT time?!!!

There was a show on the other night Mystery Diagnosis and it featured a young girl with this disease. It was pretty interesting. On the show they said the treatment was immunosupresants and steroids. They said her blisters healed pretty quickly after she got the proper treatment.

I've been a nurse for about 11 years and done wounds for about 5 years and never heard of using skin prep to 'prevent pressure sores'. The only way to prevent pressure sores is to reduce pressure. Skin prep can be used to help protect skin from moisture. I think there is a type of peri wipe that contains some skin prep for this purpose. As for the skin prep on the elbows, it may be providing a thin layer of protection against friction shear.