Many people take the approach of having PICC inserters perform an
insertion on a model before an instructor on a periodic basis using a
standardized checklist like you are asking for. But this is not the
best approach to competency assessment. Such a checklist can be used
for initial competency, but ongoing competency is quite different.
For nurses that are regularly placing PICCs, such a method will not
add any benefit to the staff, your facility or your patients.
The best method would be to look at outcomes with your PICCs.
Identify the problems or complications you are experiencing. Then
arrange to assess the aspect of your practice that will address that
part of the procedure. Ongoing competency assessment should be linked
to clinical outcomes if performance will improve.
An example would be the complication of thrombosis. You would create
a list of actions that have an affect on thrombosis development such
as catheter size selection, catheter advancement technique, tip
location, catheter stabilization. Your checklist should reflect these
steps. Assessment should preferably be in a real clinical setting on
real patients rather than an anatomical model. Using this process
what is assessed each year would change so that outcomes would
improve.
Hope this helps, Lynn
At 8:38 PM -0500 7/31/06, pam michael wrote:
Hello to all, again. I would first like to extend my thanks for
those who responded to the request for charting documentation for
'time out'. Much appreciated.
My new request is if anyone has a checklist or whatever is used for
documentation of competency (annual) for procedures related to
vascular access, be it PICC insertion, implanted port access or even
peripheral IV insertion. Of course the main competency I am
concerned about PICC insertion. If anyone out there has a checklist
that can be shared, I would appreciate it, whether it is private or
to the list. Do you do the competency yearly?
Thanks so much.
Pam Michael
--
Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
