I am the nurse PICC insertion provider in the radiology dept. Â Our radiologist insists that I am far safer placing a long wire w a soft tip then floating the PICC catheter over the wire. Â The wires now avail have a very floppy tip, and also have markings to see how far i advance. Â At one time we had "heard" that a nurse may not lead w a wire past the shoulder. Â Cannot locate anything evidence based to back up this claim. Â Have checked our state nurse practice act as well as INS standards to no avail. Â HELP??
According to the manufacture guideline of purple power PICC, the gudiewire should not be advanced past the shoulder without the fluoro guidedance.
I found out this fact while I was reading the information package that comes with the power PICC kits. It is in the warning section if you want to read.
I hope this might help you.
INS standards do not have any statements about this, however the use of long guidewires inserted past the shoulder area require the use of fluoroscopy. Does your state practice act have any statements about this? If not, that does not mean you can not do it. It may only mean that your state is one that uses the scope of practice decision tree to make scope of practice decisions.
You will always need to have policies and procedures approved by your hospital before you perform these acts. So do not be lead astray by a radiologist who is probably not a hospital employee. He or she may expect you to follow his/her way of practicing. But don't go there until you have the proper documents to support you. 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