Could everyone please comment on what your current practice is on guidewire exchanges on patients that are admitted with an outside PICC that was NOT placed at your facility and the line is no longer in appropriate position.
After a complete vascular assessment I would strongly recommend that a new PICC in a new site be placed. Since another facility was involved there is alway the question of....good technique? Good care and maintiance in other facility? Length of dwell in other facility?.....just food for thought....since it presently is mal-positioned.
I agree. The only thing you could do with the malpositioned PICC is an exchange overwire. Since you do not know the complete history of this PICC, I would prefer to remove it and place a new one. Lynn
does INS have a set standard as reference. Also what if PICC is at your facility and needs changed from single to dual or viceversa. I know I hear alot and agree about new lines but is there any policy?
There is an INS standard - #55 Central Vascular Access Device Exchange. A standard of practice is not a policy. You must read the standard and practice criteria, assess your situation and determine how your policy should be written. Lynn
After a complete vascular assessment I would strongly recommend that a new PICC in a new site be placed. Since another facility was involved there is alway the question of....good technique? Good care and maintiance in other facility? Length of dwell in other facility?.....just food for thought....since it presently is mal-positioned.
I would agree, new line, new access.
Keely Ralston RN-BC, VA-BC, CPUI, RCIS
I agree. The only thing you could do with the malpositioned PICC is an exchange overwire. Since you do not know the complete history of this PICC, I would prefer to remove it and place a new one. 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
Lynn,
does INS have a set standard as reference. Also what if PICC is at your facility and needs changed from single to dual or viceversa. I know I hear alot and agree about new lines but is there any policy?
thanks Lisa
There is an INS standard - #55 Central Vascular Access Device Exchange. A standard of practice is not a policy. You must read the standard and practice criteria, assess your situation and determine how your policy should be written. 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