See answers below in italics.
Nadine Nakazawa, RN, BS, OCN, CRNI
PICC Program Coordinator
Stanford University Hospital and Clinics
Stanford University Medical Center
From: "candee eisenhart" <[EMAIL PROTECTED]>
To: [EMAIL PROTECTED]
Subject: midlines/irritants
Date: Sat, 21 Oct 2006 18:06:29 -0700 (PDT)
Hello! I am looking for articles/studies about Midlines and the outcomes of infusing irritants (ie.Vanco and Phenergan) through.I would also like your expertise/experience regarding this practice. If you wouldn't mind writing your response to these issues I would love to hear from you please include:1. name, credentialsA. Nadine Nakazawa, RN, BS, OCN, CRNI, PICC Program Coordinator2. employment (where you work, ATU/outpatient settings, PICCteam, IV team, home settings) and employerA. Stanford Hospital & Clinics; outpatient unit, but the PICC team places PICCs in all inpatients and outpatients. PICC team consists of 5 members; we place PICCs Monday thru Friday; 2-4 nurses per day. total of 3.8 FTEs (although we need more!). 450 bed hospital with 3-4 very large outpatient areas; 1800 PICCs per year.3. what brand of lines you place, sizes, dual/single ALSO include where your "tip" resides ML and PICCs.A. Bard PowerPICCs and Groshongs; all 5 Fr; 99% dual lumens. We only place PICCs; tips at the caval-atrial junction; occasionally in distal SVC; only place tips outside of the SVC when we "can't get to the SVC" and either can IR. No midlines because we have no control over 1600 nurses and nearly as many physicians who order IV meds; plus lots of new grads and Traveler nurses and new hires. We have a low turnover rate of <6% per year, but it's still difficult to get the message across that they must screen which meds can be delivered through a midline versus a PICC.4. how you feel about using Midlines (or peripherals) to infuse these "irritants" or other irritants.A. I think midlines work very well in very well controlled settings with a well-educated nursing staff, and physicians who also understand their limitations. I just don't have that kind of control at my facility.5. any negative outcomes?I have just started at a new facility that repeatedly uses ML's for these medications. I am completely against this practice as it is a patient safty issue along with being against INS (standards). I am going to be approaching my managers and DON regarding their current practices. I need evidence and best practice/expertise to bring along with me! I plan on using any information that you all respond to, along with the INS standards.Please assist me to help our patients and help change this poor practice!Thank you in advance!Candee Eisenhart RN, CRNIMercy Gilbert Medical CenterGilbert, AZmy home # 480-458-5028cell 480-248-0376
Candee J. Eisenhart, CRNIBanner Mesa Medical CenterMesa, AZ
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