I would like to know how others define a successful insertion... Do you define it as just getting venous access (I doubt it), PICC inserted to SVC (yes this one I know), or PICC not able to thread to SVC and pulled back to Midline Position (Possibly counts)....
Thanks,
Bobbie Crider
Before I could reply, I would want to know for reason you would be using this definitioin? Competency assessment and validation? Quality outcome data collection? Other? I think there could be different answers for each use of the defintion and the stats collected. 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
I was thinking quality outcome and competency. I read things expressed as a team having a "98%" success rate. Of course it could be any percentage. The lower the success rate, the increase in supply usage, unhappy patients ect...
For competency assessment, I would define "successful" as performing the complete procedure from pt assessment all the way through to correct tip location, confirmation and documentation. The number of successful insertions required to establish competency must be decided by the facility. My personal opinion is this number should be around 5 but completion of all of this will require a lot more insertions than just 5 PICCs.
For outcome monitoring, I think you would have to know the exact outcome for each insertion and the reason why it was unsuccessful - venous obstruction/thrombosis/stenosis, aberrant venous anatomy, inserter skill, other, etc. You could have the same definition of "successful" but then would need to go further to identify the reason for those that were in the unsuccessful category.
As far as a specific percentage for what is "acceptable", obviously the goal would be 100%. You could set a goal of less than that but always be striving to reach 100%. There are no published studies or standards establishing what percentage is considered to be acceptable.
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