I was reading a forum topic on the time out procedure. One of the posts discussed the SHEA practice recommendations to prevent CLABSI in Acute Care Hospitals. The recommendation states - CVC insertion is oberved by a nurse, physcian or other healthcare personnel who has received appropriate education, to ensure that aseptic technique is maintained. I place PICC lines alone and am the only PICC trained RN in my setting. I follow INS guidelines in my practice. Does anyone know how important it is to follow every practice recommendation created? Any thoughts on this topic?
I also read that and am in the same position as you are. We are due for our joint commission survey any day now and I am afraid we are going to find out the hard way how serious they are about this recommendation.
BJ Sherman, RN
Memorial Hospital, Jasper Indiana
Joint Commission has a new set of guidelines on CLABSI out last year. Have you checked that document to see what they are saying about this? It is a free download from their website. 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
We just received our visit from Joint Commission. They noted we used a PICC team and that we documented # of needle access attempts. Just an FYI.
I remember when I first started doing PICC lines the issue arose of doing a Tiime out with only myself and the patient. . I sent a specific question to JCAHO abouth this and they replied that I did NOT need to have another person present. As long as I personally did the Time Out that it was acceptable. I even have the question and answer printed up but cant find it at this time.
I too am a one person PICC team, the only person :) . I know with recommendations verbage is a guide; where with this recommendation it says; CVC insertion should be observed by a nurse, physician, or other healthcare personnel...........
It says should, not SHALL . I am hoping this gives us some leverage if an issue does arise. When I first started doing PICC lines, it was me and another nurse , brand new, doing them( because we needed eachother for moral and troubleshooting support) When we got comfortable it seemed a waste to have 2 people in the room. We tended to send one of us out to see other patients and do other things not so much stay in the room when doing a procedure.
I had a surveryor come to me a year or two ago, ask me some questions , have me show her our documenting, she asked about time out and site marking etc. ( told her I do not site mark for a PICC line and explained why). All went well, she was well aware that I was the only one doing these procedures and no issue arose. During her visit I did not have her in to observe an insertion though.
Gina Ward R.N., VA-BC