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We have been assessing the tip
location of PICCs for about 1 1/2 years.
We presented the information to our Nursing Executive
Committee (NEC), including:
BNE information about the 6 step decision making
process to determine if it is in the scope of nursing
Chest xray for nursing
(or similar title that includes info about CVC tip locations) CE
required
Radiologists approval of the process and agreement
to sign off the PICC nurses assessing the tip correctly on 10 patients'
chest xrays
The radiologists agreement to report discrepancies in
tip location to the manager and plan the remediation
of nurses with discrepancies
Completed and signed check off list in the PICC nurses
personnel file
Annual competency not required since it is an ongoing
process about agreement of tip location by PICC nurse and
radiologist
The NEC approved the policy. The chief of
radiology signed the policy.
Gwen Irwin
Austin, Texas
----- Original Message -----
Sent: Friday, April 28, 2006 9:07
AM
Subject: RE: [vascular] Re: Productivity
for PICC dressings
Being in Texas, I would be interested in that too. We have
already been to the Bard class for x-ray interpretation. Now we are working on
trying to get it through our legal dept. Our radiologist have been on board
for quite some time, it's just convincing the rest that we can and need to do
this.
Kathleen Witt,
RN, BSN
Nutrition
Support
Presbyterian Hospital of
Dallas
214-345-7468
We are in the process of tweaking (updating) our hospital policies
and
procedures to better reflect the INS guidelines. Would someone be
willling
to share their policies related to central venous
catheters-maintenance,
dressing changes, injection cap care and change,
flushing guidelines;
drawing blood/procedure,accessing an implanted port,
cvc removal, resistance
during picc removal/troubleshooting, use of
thrombolytic agents for catheter
clearance; occlusions related to
drug/lipid precipitation; repair of
tunneled catheter.
Also, for
those of you in Texas-would like to communicate with anyone who is
currently trained to initially "OK" the line for use after
placing PICC
until the radiologist reads the film. I am interested in the
process with
which you became qualified, and how annual re-qualifications
are done,
documentation, etc. I can be reached at
[EMAIL PROTECTED] # (214)
906-4484.
Thanks as always for
your valuable input.
Cindy Hunchusky, RN
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