|
Hello!! I need some advice. The hospital I work in just went to a computer charting system less than a year ago. Some kinks are still being ironed out. One of the things we are currently working on is the documentation of our education prior to a PICC placement and also thereafter. Basically, there will be a "form" to fill out with each insertion as to what we went over. Currently, it is listed as a check box system and we check "CVC complications", "CVC advantages", "CVC care and maintenance", etc. Pretty basic statements of our education. We also have the option of "other" where we can document anything else we feel is important that was discussed with the patient. We then can check boxes as to who we taught, how we taught (demo, explanation, etc.) and also an assessment of pt. understanding (return demo, stated understanding, etc.) Some of our team mebers feel that this documentation is too broad and want it narrowed down to the following re: possible complications:
*air embolism *exit site infection *phlebitis
*bleeding *exit site necrosis *spontaneous catheter
*brachial plexus injury *extravasation tip malposition/retraction
*cardiac arrhythmia *fibrin sheath formation *thromboembolism
*cardiac tamponade *hematoma *venous thrombosis
*catheter erosion *intolerance reaction *ventricular thrombosis
through the skin to implanted device *vessel erosion
*catheter embolism *laceration of vessels or *risks normally associated
*catheter occlusion viscus with local or general
*catheter related sepsis *myocardial erosion anesthesia, surgery and
*endocarditis *perforation of vessels or post operative recovery
viscus
My thought is that this is way too narrow. How many times do we walk into a patient's room and tell them ALL of the above? We would do a lot less PICC insertions that is for sure. If you don't check the one that actually happens to the patient aren't you really setting yourself up and the institution you work for up for a major lawsuit? I always do what I feel is a thorough education of the risks and benefits of catheter placement without scaring the patient out of having it placed, especially when the patient is in a position where they have to have a central line for the therapy required. Would this also then set a standard that we can not possibly uphold? Please advise. I am newer to my team and am the only one that is not a CRNI (although hopefully after this year I will be) so I am not sure how much pull I have. I just think that sounds too extensive and not something that can be upheld.
Thank in advance~ Jenny Kettle RN, BSN
|
