We have a q am computer generated print out that's sitting in our in-box when we arrive at work...it includes: rm #, pt name, pcp, pt age, adm dx, # of days since adm, # of IV starts since adm (pulled from computer nur doc..), list of vesicants or irritants they are on and if a central line is present. We also use this form as part of our PICC QA, it's a quick way to calculate the % of piccs/bed. So, as soon as we have a quick minute, one of us sits down and quickly goes through each pt (mind you we have 120 bed facility)...we look at ratio of IV sticks/days since adm, we look at the pt's age and dx, we look at familiar names (past central line pts), we look at if they have a central line...what kind it is and how long it's been in and we look at the harsh IV meds the pt is currently on...was it a 1x dose or is it scheduled for ~10 days. After we've gathered up info and we have a pt that meets the criteria for being better off with a PICC, we call either the pt's pc nurse, charge nurse or the pcp...since some of our docs are still a little weird about piccs (most have done a 180 since we started our program 3 yrs ago and have done massive teaching to both nurses and physicians)..we don't like to just ask for a picc, instead we present info that shows the doc that this pt is a candidate for a picc and then let him/her make the decision...that's when we find out if the physician's ignorant re piccs (so we do a little teaching that's almost always well accepted) or they were about to order one when I called, or about to put another central line in or about to dc the pt on po antibx....It works well for us.
Laurie Hill, RN
Diagnostic Imaging Nurse/PICC Team Member (one of 3 nurses)
Olympic Memorial Hospital
Port Angeles, WA
We had our MIS people build us some searches:
Pharmacy searches include specific chemo meds, antibiotics and a miscellaneous
category that includes irritant veisicatn drugs like phenergan, dilantin etc. I
meet with the pharmacy MIS person and update that list annually.
We also have a report that prints census for the whole facility with diagnosis ,
age, isolation status, physician etc. It is custom for us we cross reference the
diagnoses with list our "hit list" diagnostic groups and add the drug list
references.
From there we have a jumping off point for chart review.....
Everything including our emergency room ins on line for documentation and the
physicians are in the beginning phases of computer based order entry. That
gives us a lot of info right from our office. Of course we do identify a number
of patients based on poor access as the only criteria. Those we find on rounds
for PIV placement.
Jose
Quoting "Wilkinson, Kimberly" <[EMAIL PROTECTED]>:
> Good morning,
> I'm looking for hospital's, that have a early assessment program for placing
> PICC's. May I have information on how you set up the programs and what forms
> are being used.
> Thank you for your help
> Kim Wilkinson RNII CRNI
> Wilmington DE
>
