In my opinion, this procedure should be limited to RNs, or LPNs if their scope of practice includes CVAD procedures. First there should be a patient-specific decision to use a VAD of any kind to draw a blood sample. This requires a risk vs benefit decision which can be made only by the RN. Many hospitals now are moving away from routine use of a CVAD for drawing blood. Second is the procedure itself that requires multiple connections and disconnections from the hub, the clearing of any locking solution, and proper locking at the end, and what happens when the catheter will not yield a blood return. Lab phlebotomists are not trained to manage all of this. So I would say RN/LPN only. Lynn
While not drawing blood, I am reviewing having CT techs be able to check for patency before power injection studies be performed. I know CT techs can be trained for PICC placement per their board (inTexas anyway). Of course I will be personally training then with hands on and written checkoff. The would not have to remove the cap because our caps are power rated.
While I agree with Lynn's statement, I think you were just asking about checking for blood return prior to using the cath for power injection. It is a little concerning that a tech doing these injections was not tought this prior to being able to use the access. I think it is very important for them to check this and to be trained to do so if you are allowing them to use the line. You will need to include what to do if no blood return is obtained ofcourse.
Drawing a blood sample is a very different procedure than checking for patency by aspiration. The original message stated drawing blood so that was the basis for my answer. I also would strongly support that CT techs and any one who uses any VAD for any reason be taught the complete process of site assessment which always includes aspiration for a blood return. Also remember that CT techs attend a 2 or 4 year college just like nurses. Although the focus of their education is different from nurses, they do have this post-secondary education and must be taught and held accountable for their actions just like any other professional. Others that may also be called "technicians" or "aides" may only have a few weeks of education such as a lab phlebotomists. This level of staff work under the direct supervision of others so what we delegate to them requires careful consideration and adherence to your state rules about delegation from your state board of nursing. Lynn
In my opinion, this procedure should be limited to RNs, or LPNs if their scope of practice includes CVAD procedures. First there should be a patient-specific decision to use a VAD of any kind to draw a blood sample. This requires a risk vs benefit decision which can be made only by the RN. Many hospitals now are moving away from routine use of a CVAD for drawing blood. Second is the procedure itself that requires multiple connections and disconnections from the hub, the clearing of any locking solution, and proper locking at the end, and what happens when the catheter will not yield a blood return. Lab phlebotomists are not trained to manage all of this. So I would say RN/LPN only. 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
While not drawing blood, I am reviewing having CT techs be able to check for patency before power injection studies be performed. I know CT techs can be trained for PICC placement per their board (inTexas anyway). Of course I will be personally training then with hands on and written checkoff. The would not have to remove the cap because our caps are power rated.
While I agree with Lynn's statement, I think you were just asking about checking for blood return prior to using the cath for power injection. It is a little concerning that a tech doing these injections was not tought this prior to being able to use the access. I think it is very important for them to check this and to be trained to do so if you are allowing them to use the line. You will need to include what to do if no blood return is obtained ofcourse.
Raina Pegg RN
Raina Pegg RN
Yes, currently we use RN to do this portion of the proceedure. Thanks for the tips! :)
David
Drawing a blood sample is a very different procedure than checking for patency by aspiration. The original message stated drawing blood so that was the basis for my answer. I also would strongly support that CT techs and any one who uses any VAD for any reason be taught the complete process of site assessment which always includes aspiration for a blood return. Also remember that CT techs attend a 2 or 4 year college just like nurses. Although the focus of their education is different from nurses, they do have this post-secondary education and must be taught and held accountable for their actions just like any other professional. Others that may also be called "technicians" or "aides" may only have a few weeks of education such as a lab phlebotomists. This level of staff work under the direct supervision of others so what we delegate to them requires careful consideration and adherence to your state rules about delegation from your state board of nursing. 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
In my excitement I kinda hijacked the thread. Sorry. :)