starting new hospital based picc clinic-need advice

[vasrn]

I'm a Registered Nurse at a large institution in Central Florida. We currently have a 24/7 full service IV Therapy dept. including piv, IP access, PICC insertion, and troubleshooting, care and maintenance of all types of central lines. We average between 400-500 PICC insertions a month at our campus alone, all at the bedside. Just recently, our supervisor told us that we would be starting a PICC clinic where in-patients would be brought to us by transportation, and we would also be able to do out-pt. insertions there as well. Our team members started contemplating the pros and cons of this and I thought I would bring it to this forum for help. What kind of things/issues will we be needing to tackle? Stuff like helping patients to the bathroom or putting them on bed pans, treating hypoglycemia, meds we might need access to, should we be ACLS certified (though we are hospital based and can call the code team), etc. Any insight any of you could provide would be greatly appreciated. Thanks.

[iluvivt, BSN, RN]

We have an outpatient infusion suite and we do all the PICC insertion for them......BUT we have the nurses there do ALL the other work....they take their VS...get a hx...check the orders and get them...and assist us as needed...we usually get another PICC nurse to assist with the insertion but NOT always as we often have to have the others take a lunch break...so I often say you guys go to lunch and I will have so and so assist me.....IMO. i would not have a nurse assist with a bedpan and then insert a ICC...my old school nursing says IV nurses should not do this...perhaps that is old school....IMO..the nurses should be ACLS certified..even if you have access to the team...again the more a nurse knows the better the care they can provide Coordination may be the biggest problem..for us i was anyway...b/c we also do all the acutes and you have an OP that does not want to wait...or has an MD appt in 2 hours or their ride only has 2 hours..or any stuff like that......Will the PICC nurses be based in the clinic as well as doing PICCS in the hospital........You must have control of the schedule and pts appt times or its a nightmare..to get it all done...Also make sure X-ray done in a timely manner and never to a NURSE read...all outpatients and clinic patients should not be released unless a radiologist has read the CXR...you never want a nurse read as OK...then you get the report after the pt has left and find it needs a pull back of 4 cm...I wrote this into our policy to prevent this and we all know the safe way to do this.....those are just a few of my ideas I would need to know a bit more on how you plan to do this b\c and I can give you some more ideas and thought if you so desire