Our PICC team does not perform the dsg changes- this is the responsibility of the unit nurses, as it has been for at least 18 years. Are they done perfectly? No. While an IV team would be ideal, we don't live in "PICCtopia." Our resources are presently better utilized in focusing on PICC insertion/ troubleshooting and educational endeavours. The clinical nurses should have the skills, knowledge & judgement to perform the dressings. If we find a suboptimal dressing, the educator is brought in & works with the nurse(s) who cared for the pt. It is our's & the educators' responsibility to monitor the PICC outcomes.Having said that, unfortunately, we presently do not collect outcome data to determine our infection/dislodgement incidence. However, we are, slowly (due to lack of resources) working on developing an outcome monitoring process. We are in the midst of preparing a 4-hour 'train the trainer' blitz for the
educators, which will then be disseminated to the clinical nurse to promote quality PICC care & maintenance.
DVTs: Our centre has participated in a multi-centre trial (not yet published I believe) examining upper extremity DVTs. We, for the 4 years that I've been here, leave the majority of our lines insitu if a thrombus is identified, unless the thrombosis team recommends removal, based on location of clot, lack of resolution of symptoms once low molecular weight heparin (usually Fragmin) is initiated or signs of suspected septic thrombophlebitis.
Daphne Broadhurst,
Ottawa ON
Helen lazeration <[EMAIL PROTECTED]> wrote:
DS BROADHURST <[EMAIL PROTECTED]> wrote:
Our PICC team does not perform the dsg changes- this is the responsibility of the unit nurses, as it has been for at least 18 years. Are they done perfectly? No. While an IV team would be ideal, we don't live in "PICCtopia." Our resources are presently better utilized in focusing on PICC insertion/ troubleshooting and educational endeavours. The clinical nurses have the skills, knowledge & judgement to perform the dressings. If we find a suboptimal dressing, the educator is brought in & works with the nurse(s) who cared for the pt. It is our's & the educators' responsibility to monitor the PICC outcomes.Having said that, unfortunately, we presently do not collect outcome data to determine our infection/dislodgement incidence. However, we are, slowly (due to lack of resources) working on developing an outcome monitoring process. We are in the midst of preparing a 4-hour 'train the trainer' blitz for the educators, which will then be disseminated to the clinical nurse to promote quality PICC care & maintenance.DVTs: Our centre has participated in a multi-centre trial (not yet published I believe) examining upper extremity DVTs. We, for the 4 years that I've been here, leave the majority of our lines insitu if a thrombus is identified, unless the thrombosis team recommends removal, based on location of clot, lack of resolution of symptoms once low molecular weight heparin (usually Fragmin) is initiated or signs of suspected septic thrombophlebitis.Daphne Broadhurst,Ottawa ON
Helen lazeration <[EMAIL PROTECTED]> wrote:Need some help with two items:Just need an informal survey on how many facilities have their IV/PICC Teams do the routine dressing changes or if the nursing staff do the changes and how everyone feels about the nursing staff on the floors doing the routine dressing changes.Also, if there are any facilities out there who have physicians leave a PICC in place with a DVT and anti-coagulate the patient to try and break down the DVT? If so, do you have a policy/procedure in place for this scenario that you would be willing to share?Helen Lazeration, CRNIFairbanks Memorial HospitalFairbanks, Alaska
