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Wed, 06/20/2007 - 08:04

gretchen

outpatient PICCs

I am the 'new' Pediatric PICC RN at OU Medical Center in OKC.Â I have done neonatal PICCs in the past, so this particular subject has never come up!

We have had an increasing need for outpatient PICCs.Â We do not currently have a system in use to accomplish this.Â Within the past couple of weeks,Â several patients haveÂ been referredÂ to theÂ ER (by their Dr.)Â just to get a PICC.Â ER is not excited about this, and it is inappropriate.Â I have also had some clinics call and request an outpatient PICC.Â The only way we have been able to accomplish this is to have the patient admitted to the hospital asÂ observation.Â We have had to do this in order to get the patient into our system to be able to make supply charges, take XRAY's, and document.

Do any of you have a organized system in use for outpatient PICCs, and if so please describe!Â Also, do you set aside a day a week to do outpatient PICCs or so many hours each day???

Any information is greatly appreciated!

Gretchen

Wed, 06/20/2007 - 10:09

Angela Lee

We have had some of the same

We have had some of the same issues from time to time. If the patient's MD is on staff here we can usually get them into one of our clinics depending on their diagnosis (ortho, ID, surgery, etc.). If the Md is not on staff then we have to have one of our physicians accept the patient so they can be entered into the system and we can get orders. If a patient will need sedation we bring them into our one day unit, they get an H&P, orders, sedation screening and the procedure is done and they are discharged. It can be frustrating. Although we have placed them in the ED we try to avoid it for several reasons including inappropriate use of the Ed. We do not place outpatient PICCs on any specific day because they do not occur frequently.

Wed, 06/20/2007 - 13:41

Kelly Smith

In our facility, we have an

In our facility, we have an outpatient service area called multiservices where outpatient infusions, injections, consults etc. happen. We place all inpatient and outpatient piccs in this department. This works really well in our facility. We do not have an iv therapy team.

Kelly Smith

PICC Nurse

Boone Hospital Center

Columbia, Missouri

Thu, 06/21/2007 - 05:53

maggiemonahan

We have our patients come to

We have our patients come to a room in our outpatient care center. They go to the main registration desk to sign in and then registration calls to see if we are ready for them. This is a service that the hospital can bill the patient for. In this area is the IV Infusion Department, where outpatients receive chemotherapy, antibiotics, blood transfusions etc.

Thu, 06/21/2007 - 09:05

anna liang

We have the kids admitted

We have the kids admitted for in-patient.

last Friday there was a request from clinic to place PICC for a 9 years old with wound infection not repsonse to oral antibiotic.

The child was admitted Monday for picc placement with sedation. the plan was discharge home the same date.

The child was coded (resp arrest) during the recovery phrase.

Thu, 06/21/2007 - 19:29

tinacrni

My patients are adults, and

My patients are adults, and unfortunately I don't do many PICCs anymore because of the interventional radiologist (no one will list to my information regarding costs), but I do have a doctor who will call me and ask to place a PICC. They are admitted through outpatient infusion center. This way there is not exactly a bed charge, but I am able to provide the placement, x-ray, and care in an appropriate manner.

Tina

Sat, 06/23/2007 - 22:05

Jan Wesselink

Do you have an ambulatory

Do you have an ambulatory care center? The outpatient would make an appointment, and the ACC would call us when they got there.

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