Here we go again discussing LTC patients. The reality is that not accepting the patient is not an option for any LTC facility. If they refuse a patient, they can seriously damage the relationship with the referral source, and they cannot afford to do that, they need every patient they can get. Also, most admissions people at LTC facilities are NOT nurses, so they have NO idea what a PIC or PICC is, or where it should be. It is a rare facility that gets the DON or other nurse involved in the admissions process. So, most of the time (99%) the staff nurses have to work with what they get when it arrives, and the hospitals are VERY difficult to work with to get any information out of once the patient is at the facility.
My recommendation to this facility would be to work with the DON to get her support and write a policy to request that they order a chest xray on all patients with anything other than a PIV when they arrive. After they get the chest xray results, they can then contact the MD for orders, stating that their policy is not to use midclavicular catheters at that facility. Suggest that they pull them back to Midlines as an alternative, or use their line placement service to replace to a PICC if they need a central line. (like for Vanco)
The only way they would be protected from backlash from the MD is with a facility specific policy.
You may also want to suggest they get one or two nurses trained to place PICC lines, which would decrease the costs involved in getting these lines replaced. Does your pharmacy offer a PICC class? I found that to be very effective in getting the right line for the right patients.
Chris Cavanaugh, CRNI
----- Original Message -----
From: [EMAIL PROTECTED]
Date: Thursday, March 16, 2006 1:42 am
Subject: Re: Midclavicular catheters
To: [EMAIL PROTECTED], [EMAIL PROTECTED], [EMAIL PROTECTED]
> Also, the term PIC is outdated. This was determined years ago to
> be confusing and inappropriate terminology, not to mention unsafe
> tip termination.
> LA
>
> -----Original Message-----
> From: Lynn Hadaway <[EMAIL PROTECTED]>
> To: Dawn Ellis <[EMAIL PROTECTED]>; [EMAIL PROTECTED]
> Sent: Wed, 15 Mar 2006 16:01:23 -0500
> Subject: Re!
: Midclav
