Thank you all for your great feedback. I do not know if there was a specific incident that triggered all this. The discussion came up at a physicians group meeting where they were discussing the start of our 100000 lives campaign. While discussiong the changes the MDs were going to make with placement of central lines, one of the surgeons came up with the idea that all patients getting central lines should be on telemetry and from that discussion...PICCs came up. I know our Vascular access team has seen a few patients with V tach when the atrium is "tickled" by the PICC. This has always cleared up when the PICC was pulled back into the SVC. My problem with requiring telemetry system wide is that I oversee the inpatient IV teams in two hospitals as well as the outpatient infusion teams at both hospitals. All of these nurses place PICCs. A few of them have ACLS but the majority aren't. While those patients on telemetry units are not the issue, the outpatient and some smaller medical floors are a different story. I think we would need additional training in the use of a portable telemetry unit. I understand that this might be a good idea, but again we have not had any serious patient problems from not doing this. Is anyone out there doing telemetry specific for PICC placement?
Sue Kilbourne CRNI, OCN
Asante Health Systems
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