Our cardiologists want us to use the opposite arm unless
there is a contraindication like mastectomy. Then we call to get the ok to use
the same side. We have only had to do this twice that I can think of in the
last several years.
Kathleen Witt, RN
Nutrition Support
Presbyterian Hospital of
Dallas
214-345-7468
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Ward Gina
Sent: Wednesday, March 01, 2006 12:44 PM
To: [EMAIL PROTECTED]; [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: RE: insertion of picc in pacer site
What is the general consensus on putting a
picc in on a site with a pacer? does it need to stay opposite
side. If it has been in a long time is that ok? Definite
contraindication?
I am relatively new to this .
Thanks Gina
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
Sent: Mon 2/27/2006 1:37 PM
To: Ward Gina; [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: Re: dressing changes and protocol/procedures for DVT in PICC Arm
When we first started our program 12 years ago we did the same thing. All
the dressings. What we found was that by the PICC team doing the dressing
the nursing staff did not take complete ownership for the line. The PICC became the property of the PICC team. That was a problem when there were
issues on the off shifts.
We educated every nurse in the hospital and now capture the new hires
during orientation.
We also have what we call expert
resource nurses. Theses nurse can tPA,
and remove PICC's, . They are the ones the
staff is to call first to trouble shoot
their lines if they have a problem.
This is working good.
We hold the classes for the resource nurse quarterly.
Linda Lembo
New Jersey
New Jersey
-----Original Message-----
From: Ward Gina <[EMAIL PROTECTED]com>
To: Helen lazeration <[EMAIL PROTECTED]>; [EMAIL PROTECTED]
Sent: Mon, 27 Feb 2006 09:22:29 -0500
Subject: RE: dressing changes and protocol/procedures for DVT in PICC Arm
We the 2 trained PICC nurses (myself and
another nurse), who also work fulltime in
other areas in the hospital, do all the PICC dressing changes. We
know they (floor and ICU nurses ) have
done Central line dressing changes in the past, but we also know what they end
up looking like and have seen some of them in action.
We just started our PICC program 5
months ago, we wanted to keep it a smooth as process as possible and keep
our complications down to a minimum. So, we decided we would do all the
drssing changes. We did provide a class for
all nursing staff on care of and use of the picc. The nurses are elated and we have had no problems with
infections. We also chose to use the Biopatch dressing to make our dressing changes down to every 7 days
after the initial 24 hour change.
We initiate a file on each pt and also a log to keep up with the dressing
changes, it has worked well so far. Of course we do only about 20-30 piccs a month and our average length of stay for
our lines is about 14 days.
We have not had to deal with DVTS yet.
Thanks, Gina
From: [EMAIL PROTECTED] on behalf of Helen lazeration
Sent: Sat 2/25/2006 3:18 PM
To: [EMAIL PROTECTED]
Subject: dressing changes and protocol/procedures for DVT in PICC Arm
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, CRNI
Fairbanks Memorial Hospital
Fairbanks, Alaska
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