Our hospital is only using power PICCs. I think some insertion difficulties on triple power is related to their size and the power-enabled material (there are other factors, but that is not my focus here). I do not think that everyone needs a power, but I have to prove it by showing EBP on price, complications, etc. I am studying our data and formulating a plan.
Does anyone have articles that helped them at their facility with these issues? I have looked at the work by Teratola.
Does anyone use both power and non PICCs and can you share your insertion criteria used to determine which one the patient needs? I don't think this is as straight-forward as it might appear.
Does anyone have cost data? I'll take even just the cost difference of your PICCs, but I really wonder if anyone has been able to measure/estimate the costs that arise from complications of Power (esp. Triple) vs. those of non-power.
Thank you!
When you say power vs. non-power do you mean polyurethane vs. silicone?
We do experience more threading problems with the polyurethane blunt ended catheters. The often seem to "catch" at the IJ/BC junction. It's usually resolved by making the tip floppy and advance slowly. It's also very helpful to bring the arm over the head when threading past this area, it straighten outs the tight bend and the catheter will usually drop.
We have seen no directly related complications to either catheter but we are choosing power with much more frequency because everybody seems to need contrast these days.
Darilyn Cole, RN, CRNI, VA-BC
PICC Team Mercy General Hospital Sacramento, CA
Thanks for the reply. When I say power, I mean capable of contrast media injections. Thanks for the tips!
Kathleen Wilson, CRNI
I do not think every patient needs a power PICC!! I have had several patients (one of them was an RN) who have had PICCs several times and actually told me the poly and silicone were much more comfortable than the power PICCs. We have to think about what the patient needs AND trying to preserve veins for future use. Trying to place large catheters and stiff catheters "just because we can" may damage a vein for future use. I am not that involved with cost factor but do know that the Power kit is way more expensive than using a standard kit and adding the catheter needed and have been told that those supplies are not paid for by the insurance company since they are under a certain amount of money, but the more expensive kit is. Marjorie Ashley CRNI Fall River, MA
To my knowledge there is only one power-injectable PICC made of silicone - Groshong. All others are made of polyurethane. 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