Hi Wendy
Thanks for your response. I am not sure what our outcome will be as
discussions are ongoing currently to resolve this issue. Perhaps we will
eventually review our own films but change takes place very slowly; I
understand many nurses in the US read their own xrays following PICC
placement.
Will be attending the AVA conference next week so will have info to bring
back re same.
Patrice
----- Original Message -----
From: "Erickson, Wendy" <[EMAIL PROTECTED]>
To: "James N Wilken" <[EMAIL PROTECTED]>; <[EMAIL PROTECTED]>;
<[EMAIL PROTECTED]>
Sent: Friday, January 06, 2006 10:51 AM
Subject: RE: Determining PICC Tip Location
We occasionally have the same problem with tip locations - the lead
radiology tech does the initial read of the film and calls us and we
give the "OK to use" order to the staff nurse. What we have happen is
we place a PICC very easily, threads easily the whole distance, no
problems - and then they call and say it's in the axilla or subclavian
vein and to replace it. OK - so where is the rest of the catheter we
inserted!? They are not pleased when we ask them to redo the xray, but
we have held firm and every single time, the second xray shows in the
SVC. Rarely the radiologist will follow-up when they read the film and
call us if they disagree with the lead tech's read. We now have a
computer xray system so we can actually pull up the film ourselves and
look at the film. We are often more accurate than the techs.
Wendy Erickson
Luther Midelfort - Mayo Health System
Eau Claire WI
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of James N Wilken
Sent: Friday, January 06, 2006 10:37 AM
To: [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: Determining PICC Tip Location
Hi Sarah,
When you say that you only place the lines and do not follow them after
placement, does this mean that you do not follow up for confirmation of
tip placement? And if not, who does?
Our radiologists have indicated to us that they will provide a hard copy
for the chart of their findings re PICC tip placement within 48 hours of
reading same and so the residents are releasing the PICCs for use.
Sometimes we are asked to pull the line back only to find out afterwards
that it was in a good position prior to pulling back and ends up in less
than optimum location.
What are others doing for tip determination? Any suggestions?
Patrice Wilken
Vascular Access Team
Winnipeg, Manitoba
----- Original Message -----
From: [EMAIL PROTECTED]
To: [EMAIL PROTECTED] ; [EMAIL PROTECTED]
Sent: Thursday, January 05, 2006 4:07 PM
Subject: Re: PICC insertions
I work in a 140 bed community hospital. I have a total of 5
nurses (counting myself) that place PICC lines. All of my nurses are
also chemotherapy trained. We work out of an outpt infusion service
department. We are open 8-4:30. Our lines are not pre-scheduled, we
just fit them into our schedule. Gets a little hectic on Fridays at
3pm. We have 8 hr wkend and holiday on-call coverage. We use MST/US
for placement. We don't have IR who place lines, but they will help
reposition under fluoro if we have a difficult placement. We only
place the lines, we do not follow them after placement.
Sarah Jones RN, BSN, OCN, CRNI
Oncology Nurse Clinician/Infusion Services Coordinator
Upper Valley Medical Center
T: (937) 440-4827
[EMAIL PROTECTED]
Sent by: [EMAIL PROTECTED]
01/05/2006 04:31 PM
To: [EMAIL PROTECTED]
cc:
Subject: PICC insertions
We are an approximately 250 bed community hospital At present,
the PICC lines inserted at our facility are done by one of four
individuals that comprise our PICC team That team is two Nurse Managers
who were willing to take this on as an additional duty, and two RNs
employed to provide Nutritional Support Services (follow all central
access devises, monitor tube fed patients). We provide service M-F
08-430.
My question is, what do other facilities this size and type do
to provide PICC insertion services? Do you contract to an IV company?
Use Interventional Radiology? Dedicated team? Thanks in advance for
any information you can provide.
Lisa Kasten
Lisa Kasten RN, MSN, CNA, BC
Nurse Manager Med/Onc
Memorial Hospital
[EMAIL PROTECTED]
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