I think all of you are describing a very desirable situation - too
much business. Years ago, one of the IV team managers use the
strategy of entrenchment. That IV team would always accept more work,
more challenges, more services we could provide. The goal was to
entrench that IV so deeply into the culture of that hospital that
they would never think of doing away with this team. That was 25
years ago. Today this team is still functioning. They have lost FTEs
and restructure the work they do but there was never a hint of
disbanding the team. Lynn
At 10:05 AM -0900 1/4/06, Betsy Harmon wrote:
The Best Practice of infusing vasopressors with a central line is great. We
at our institution hav attempted to establish this. The problem is that
when the Vascular Access Team points this out the Physicians say "put in a
PICC". We have 2 full staff members on our team. We are in the same
situation you are. We also do a fairly extensive consult on the patient.
What is the past medical hx, current underlying problems, past surgeries,
were they "PICCable" in the past, and here is the kicker. How many drips,
medications, IVF are they on for sedation and vasopressors? Are all of them
compatible? Can everything go through a dual lumen? Does the patient have
the vasculature for a Triple lumen? Most of our patients do not have the
vasculature for a triple lumen PICC. We off the physicians two duals and
also with the caveat that we use Groshong PICC's for the most. If this
patient tanks and they need to use the rapid infuser there may be a problem.
Most of the physicians end up placing a non-tunnled TLC for 7-10days and the
patient stabilizes out and we then place a PICC.
Our nurses are calling for central access faster than the physicians can
think of it and if we consult the patient prior to a MD order then we state
in our consult if the patient is "PICCable" or due to incompatibilities or
vasculature the patient needs a TLC for a short time.
Don't know if this helps, will be looking forward to others answers.
Betsy Harmon RN BSN CRNI
Vascular Access Team
Critical Care Unit
Alaska Narive Medical Center
Anchorage, Alaska
[EMAIL PROTECTED]
----- Original Message -----
From: "Wendy Boersma" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Tuesday, January 03, 2006 12:29 PM
Subject: Vasopressors
I would just like to hear from those who have a policy regarding the
infusion of vasopressors with a central line. The big push right now is
that all vasopressors must be infused via a central line. I'm not
arguing this to be a bad point with the exception that they would like
this to be a PICC Line. This supports the use of PICCs within the
facility but unfortunately there is not adequate staff to facilitate
this practice.
So I am wondering what others are doing. Maybe this will increase
staffing and coverage to 24/7..... :)
Wendy Boersma, RN, BSN, CRNI
Throughput and PICC Services Manager
269-966-8591 or pager 269-410-0385
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Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
