My quality improvement project for the upcoming year will focus on getting PICC lines placed within 72 hours of admission. Even though we have a fairly active program of early identification, and daily assessment for appropriateness of IV access, we still have patients who slip through, and end up getting several peripherals before a PICC is ordered. Improvements in this area can diminish patient suffering, shorten length of stay, and decrease the cost of care.
A key element of this project is to develop a small laminated reference card with well organized, clearly stated indications for line placement, that I can distribute to the physicians and nurses. But I'm really busy, and don't have time to reinvent the wheel. I bet several of you have tools like this that you have created and refined. BARD issued some little cards in 1998 with their Assessment Advantage program, but I want to boil it down to one card, with criteria that include projected length of therapy, type of therapy, and patient diagnoses or conditions which would indicate need for a line. Did I leave anything out?
Jerry Bartholomew RN BSN CRNI
Vascular Access Specialist
Veterans Affairs Medical Center
Spokane, Washington
