Betsy, In reading most of the responses, I think your times were closer to the norm. With the exception of some who chose to embellish or prevaricate. Time and motion studies have been done on these procedures and it is impossible to accomplish what was reported earlier in the week. Looks like your team is quite productive.
Roger --- Elizabeth Harmon <[EMAIL PROTECTED]> wrote: > In reading this question I was amazed what people > are attempting to do in short amounts of time. > > In our facility we are strictly a consult service > and we allot approximately 30min for a consult. > This is after we have recieved the faxed consult > from the floor RN or physician. We do a thorough > chart review of past possible PICC's, current > medication, disease process, current VAD, assess the > patient with ultrasound. Chart our findings and > contact the Physician with them. If there is an > order for a PICC and the patient is "PICCable" then > we proceed at our earliest convience. We have 24 > hours to respond to the consult. Most of the time > we are able to get the PICC placed that day or > within 24 hours. > > The time for placing a PICC varies as with each > patient. I have spent 3hours attempting to get the > PICC into the Dist SVC only to have it go up the L > and R jugular and then cross over into the opposite > SC. We do not limit a time to place PICC's. > Because we have all necessary items on the Acute > care floors to place PICC's we just acquire the > items from the Pyxsis. Obtaining consent sometimes > can be the hangup because if family is not in the > room you have to wait for them. Once consent > obtained, get supplies, sterile field, etc.... > Get xray for a STAT PCXR (that's where is can be a > problem). They usually respond to ICU faster than > the floors and if you are on the floors it sometimes > can take a while. We have managed to deal with this > by getting to know our xray techs. Contacting them > just prior to attempting a PICC and let them know > they are going to be beeped for this room. This has > helped immensly.(?sp)? > > Finishing up the paperwork and making sure all the > orders are signed and filled out correctly. We have > a pre-set of flush orders for NS and Heparin Flush > of all our VAD's to which once the Physician say's > ok to distal tip placement we sign a verbal. We > also remain in sterile garb until the PCXR is read. > Our physicians/residents/PAC's all know that we > cannot wait for them to get out of a meeting. The > radiologists also read the tip placement for us and > the ER physicians. > > So realistically the time spent on the average for > placement of a PICC is about 2 hours. This is > addition to the time spent for a consult. > > All of our floor/ICU/staff RN's do dressing changes, > if there is a problem they send a consult and we > then assess what is needed, increased teaching, > contacting the MD, placing a different dressing, > etc......Our Vascular Access Team is quite atonomous > and it works well for our facility. > > Contact me if you would like anymore information. > > Betsy Harmon RN CRNI > Vascular Access Team > Critical Care Unit > Alaska Native Medical Center > [EMAIL PROTECTED] > ----- Original Message ----- > From: [EMAIL PROTECTED] > To: [EMAIL PROTECTED] ; [EMAIL PROTECTED] > Sent: Friday, April 14, 2006 9:58 AM > Subject: Productivity for PICC dressings > > > Below is a Question recently posted but not > answered in full by anyone--There is no way in the > real world that a skilled/professional PICC nurse > can verify an order--assess the patient for > placement appropriateness and anatomical > accessabilty--obtain informed consent--measure and > prep patient--establish a large sterile > field--administer local anesth--puncture and vein > capture--MST advancement of catheter--apply sterile > dressing--obtain STAT portable--fill out a mound of > paper work while waiting for XR confirmation in 30 > or 45 minutes--those numbers are totally unrealistic > and misleading in the hospital bedside environ where > ONE nurse is responsible to do all of the > aforementioned steps--and let us not forget to > factor in TIME for troubleshooting/complications or > repositioning etc....20min for drsg change but > 30-45min for PICC insertion??? GET REAL!!! > > Robbin K. George RN > Vascular Access Resource > Alexandria Hospital Virginia > > ---------------------------------------------------------------------------------- > > I would like to know from those of you who do picc > dressings how much time you get for productivity. > > Should this time include collecting supplies and > charting? > > I would also like to know how much time you are > alloted for PICC placements with ultrasound. > > Thanks for your help. > > Darilyn Cole, RN CRNI > Mercy Healthcare Sacramento > > --------------------------------------------------------------------------------- > We are allotted 20 min. for central line dressing > changes and 45 min. > for picc placements in our RVU conversion for > productivity. > > Cheryl Barrett RN, BSN, CRNI > > IV Coordinator > > Erlanger Health System > > 423-778-2472 > > --------------------------------------------------------------------------------- > We are allotted 2 hours per PICC- try to place 4 > in an 8 hour day, and 6 in > a 12 hour day... including paperwork and > ordering/gathering supplies. > > --------------------------------------------------------------------------------- > We allotted 30 min per PICC and 20 min for > dressing changes. > > Doug > --------------------------------------------------------------------------------- __________________________________________________ Do You Yahoo!? Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com
