Who places your PICC lines?

[ECBSN]

In the small hospitals less than 100 beds I would like to know how you get PICC lines placed.

Do you have an IV team?

or

Do you have nurses who leave their patients (or other jobs) to put them in.

If it is the later, do you have an on call nurse? Are their problems getting someone? Do they recveive extra pay?

[christianRN]

We have a very small group of nurses who are PICC-trained. Scheduling is sometimes difficult, and we are trying to get another class approved so there will be more of us to go around. A couple interventional radiologists will place them if we are unable (They use flouro). There are also private companies that can be contracted.

[dian57]

Recent policy change here: PICCs are placed by surgeons in the OR of our community hospital. Can be removed only by IV certified RN at bedside.

[Daytonite, BSN, RN]

Until the IV Team I worked on was given the OK for all of us to be trained at insertion, PICCs were inserted by a nurse specialist who was trained at it. The only doctors in the facility who did them were the procedure radiologists who did them under fluroscopy. Have you tried getting the subject of PICC line insertion on the agenda of the medical staff meetings? It helps greatly if you have the support of the medical staff on this because you ultimately have to have a doctor's order in order to insert a PICC in the first place. If the doctors aren't going to go for it, you can pretty much forget about it becoming reality at your facility. Some physician education might be called for. The Intravenous Nurses Society (INS) has all the stats and information put together on nurse insertions and infection rates for presentation to the docs. You might want to get a willing doc on your side, get this information pack from the INS and ask to do a presentation at one of the medical staff meetings. You should also get someone from nursing administration who is agreeable to this as well so they don't think you're stepping on toes. The on call nurses who do insertions are those working with home IV infusion companies and I think you have to hire them as an outside contractor. I would strongly recommend that you contact the INS and tell them what you are trying to accomplish since they are very experienced at advising on these things. They have a website.

[Zee_RN, BSN, RN]

PICC lines are inserted by the "PICC team"--a couple of nurses who circulate through the hospital as the IV/PICC team. They primarily do PICC line insertions. They do ultrasound-guided PICC insertion;they are specially trained for this procedure. If they are unable, then the pt. goes to Radiology for PICC placement under fluoroscopy (the only problem being the pt. must have a peripheral site in place already for the fluoro procedure).

At our hospital, PICC insertions are never considered STAT so there are no "call-ins" of the PICC nurses for PICC placement; if you need a line STAT, you need a surgeon or intensivist or PA there to insert a central line. The PICC team works Mon-Fri daylight and they are very busy.