Do any of you all have practitioners that will take a PICC catheter and tunnel it on the chest to the subclavian, EJ or IJ? If so, do RNs remove these catheters? We have not in the past removed tunneled catheters but they used to always have a cuff. Since these are not cuffed I am getting some push back from the inserters for our team to remove them. I notice in the new NS standards, they mention only implanted port removals as a medical act.
Theresa Reed
Texas Children's Hospital
Removal of catheters without a subq cuff but tunneled can be removed without surgical dissection needed to remove the subq cuff. So a nurse with documented competency should be able to remove them. You would need to learn if any sutures have been used by the inserters but infusion nurses should be able to remove a tunneled non-cuffed catheter. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Where would I find the information for competency on a procedure such as this? Basically, remove it like a non tunneled catheter or PICC but apply pressure at the site of vein insertion as opposed to the catheter exit site? I just want to make sure I am not over looking something obvious. Thanks for your responses. Theresa
I can't give you a single resource for this competency. You will need to do some investigation with the providers who are inserting these lines. I would want to know which vein is being used - subclavian or IJ - and if and where they are using any sutures in this process, and to ensure that they are never using a brand that has a subcutaneous cuff. Get feedback from the inserters about how they are being inserted, then go from there to create a competency assessment process for removal using your internal standardized forms, etc. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861