Ultrasound PICC

[moonshadeau, ADN, BSN, MSN, RN, APN, NP, CNS]

For those of you that do place or know of a team that places PICCS, are the nurses required to go through additional training on the use of ultrasound? Any advice would be greatly appreciated. Thanks:redpinkhe

[JOPICCRN5]

Our most recent trainees are taught during the PICC class to use ultrasound with no additional training given. But when they do their practice during the training they dont use the ultrasound. Does that help? I am located in Iowa. Our PICC team uses ultrasound.

[iluvivt, BSN, RN]

Keepin mind that research shows that it takes 20-50 Ultrasound PICC insertions to feel comfortable using the US. Nurses with previous non-US PICC insertion experience seem to catch on faster. Nurses that are starting from scratch take longer and need lots of encouragement as it seems a bit overwhelming for them. This has been my experince since the introduction of US in our practice. We have trained quite a few nurses for our sister hospital and new additions to our team.

[owensmommy]

We recently started training nurses US guided PICC insertion. All nurses that are becoming "PICC certified" are trained in the use of the machine.

[accessqueen]

I can't imagine placing a PICC with ultrasound without training on the ultra sound. There's so many little things that are involved that without help your success rate would be pretty bad.

[momdogz]

Ultrasound guidance for all CVC, including PICC, placement is now the standard. There is a large body of evidence to prove that it reduces complications for patients.

Our PICC training program (for qualified RN's and MDs - any state) contains a specific ultrasound guided cannulation component - it is essential that the PICC RN understand basic ultrasonography. Part of our curriculum is from Blue Phantom (Brian Keegan).

Mari

[jenzmom]

I am a new Clinical Ed. Coordinator at a rural Critical Access hospital in SE Iowa. We are looking at implementing PICC in our facility, however, don't have anyone trained. Where do we get started? Also I don't know if we would have sufficient volume to keep our nurses adequately competent and confident to perform this procedure. Any ideas?

[accessqueen]

The place to get started would be to call the reps from whichever company would be supplying the PICCs. As an example, BARD which is who we use, has an on-line PICC insertion course. That is the starting point. When you complete the course they send out representatives who will train you. HOWEVER. I strongly suggest that you recruit an experienced PICC nurse. In order to gain the confidence of the ordering physicians, you have to be good. You can't be good until you've had adequate experience. If you start out with a bad track record, you will not build up volume, and you will not become proficient. In our 90-100 bed hospital we place between 70-100 PICc's a month. In patient and out patient. But we didn't start out that way. The team we replaced were NOT very good and the docs did not want to order PICC lines. We had to prove ourselves, and I was able to do that because I came in with years of experience and then trained the team. The company reps are usu flying in from some place to dedicate a weekend or a few days to do training. However, if you don't have the volume, they can't train you. Which goes back to having a trained person on the team. Also don't train a whole bunch of people who are not ever going to be very good. Focus on a designated one or two nurses and get good!! Using ICU nurses to put in PICC's prn is a recipe for disaster. Good luck!

[jenzmom]

Thank you for the info. I'm just afraid that we won't have the volume. We are only 25 beds, ADC=10-11 pts. We have one nurse who only works prn, who has had PICC experience in the past, but needs a refresher.