i agree that good technical support staff can be an absolute blessing with appropriate orientation and supervision. we train families with little or no education to perform many tasks that could be done by technicians and i realize this is a hospital setting and we are liable but we shouldnt throw the baby out with the bath water.
>>> "Ratz, Karen" <[EMAIL PROTECTED]> 03/02/06 7:54 AM >>> I have been following all the posting on this issue. To answer a few of the questions--a nursing technician is a non professional staff member that is overseen by a professional(i.e.RN or LPN). At our institution their usual responsibilites are to assist the staff with baths, walks,vitals, accuchecks,secretarial duties,etc. For our line care tech, they have been specifically trained for this job. They attend an orientation to sterile procedure in the OR. This is usually 2-3 full days of placing gowns, gloves on correctly , opening sterile packages and maintaining a sterile field. They then must be trained by another line care tech or PICC nurse. This process is usually a couple weeks. They are taught to look for complications at the site of insertion (i.e.redness,drainage). If they find this, they will call the PICC nurse and we will look at the site. They also look for swelling of the arm. We still do once a week arm measurements. The techs do this and again inform the PIC! C team if they notice increasing arm measurements. We the PICC nurses work very closely with the techs. We still hold the nursing staff ultimitaley responsible for the assessment of the PICC. The line care techs work well at our facility. Our infection rates are extremely low. I attribute this to the dedication of these techs. I would much rather have 3 specifically trained techs doing sterile technique that they are very good at it, as opposed to 300 nurses doing varying degrees of sterile technique. One of the biggest challenges though is the monotony of the job. They are doing the same thing over and over again. We are fortunate to have some good techs right now. ________________________________ From: Henderson, Karin [mailto:[EMAIL PROTECTED] Sent: Thu 3/2/2006 6:30 AM To: 'Kokotis, Kathy'; Henderson, Karin ; Ratz, Karen; Helen lazeration; [EMAIL PROTECTED] Subject: RE: dressing changes and protocol/procedures for DVT in PICC Arm While I absolutely agree that we can teach and that many techs can fit nicely into this model, in NC, even LPNs cannot do initial assessments and RNsmust assess for any changes in patient status. But I agree that in the future, (which is now), we need to push the envelop to support nursing and optimize patient care -----Original Message----- From: Kokotis, Kathy [mailto:[EMAIL PROTECTED] Sent: Wednesday, March 01, 2006 5:57 PM To: Henderson, Karin; Ratz, Karen; Helen lazeration; [EMAIL PROTECTED] Subject: RE: dressing changes and protocol/procedures for DVT in PICC Arm Technicians have been used in the battlefield for years. We could teach them to assess better than the staff RN's for redness, drainage, swelling etc. Would you rather have staff nurses never do dressings or site inspections or techs that are competency trained. I like the idea of techs. It fits with the hospital re-design I see for the future Kathy ________________________________ From: Henderson, Karin [mailto:[EMAIL PROTECTED] Sent: Tue 2/28/2006 2:19 PM To: Kokotis, Kathy; Ratz, Karen; Helen lazeration; [EMAIL PROTECTED] Subject: RE: dressing changes and protocol/procedures for DVT in PICC Arm I'm very interested in the idea...just wondering, since "assessment" is not in the "scope of practice" for techs, if this is an issue? -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of Kokotis, Kathy Sent: Tuesday, February 28, 2006 1:45 PM To: Ratz, Karen; Helen lazeration; [EMAIL PROTECTED] Subject: RE: dressing changes and protocol/procedures for DVT in PICC Arm This is the future - talked about this same concept today in my lecure This is how we reduce CVC infections - line teams with technicians reporting to the vascular access service Flow process control at its best I love this!!! Kathy ________________________________ From: [EMAIL PROTECTED] on behalf of Ratz, Karen Sent: Tue 2/28/2006 5:36 AM To: Helen lazeration; [EMAIL PROTECTED] Subject: RE: dressing changes and protocol/procedures for DVT in PICC Arm We have a line care team that is responsible for all the dressing changes to subclavian, jugular, arterial , Hickman and PICC lines. They are nursing technicians that perform this task. We have 1 full time and 2 others that are part time. They perform the dressing change with sterile gown,sterile gloves and the large sterile drape,chloraprep, and the biopatch. They also wear the mask and hair bonnet. We had 1 PICC infection last year and 0 central line infections. The technicians also assist us with PICC insertions if not busy with dressing changes. ________________________________ From: [EMAIL PROTECTED] on behalf of Helen lazeration Sent: Sat 2/25/2006 2:18 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 ******************************************** This message and accompanying documents are covered by the Electronic Communications Privacy Act, 18 U.S.C. §§ 2510-2521, and contain information intended for the specified individual(s) only. This information is confidential. If you are not the intended recipient or an agent responsible for delivering it to the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, copying, or the taking of any action based on the contents of this information is strictly prohibited. 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