Our PICC team has gradually evolved to the IV team. Over the years, the PICC team would assist with difficult PIVs here and there. Hospital staff either do not have the skill set or basic foundation to insert PIVs in patients that are difficult sticks. It eventually snowballed and the PICC orders were taking a back seat to the ultrasound PIV orders. The Director put a screeching halt to the PICC team placing any ultrasound PIVs. Of course this got everyone’s attention! If the PICC team is going to take ownership of all the PIV sticks, then we need additional staff. I am trying to research this topic to see what other facilities are doing. Anyone interested in providing input or answering the questionnaire below or email privately to: [email protected]
Facility Name:
Contact Name/Title:
Contact Number:
# of beds at your facility:
Does facility have a PICC team and/or an IV Team? (please specify):
If PICC team – what types of lines are placed strictly by the PICC team?
If IV team - how are PIVs inserted (traditional or ultrasound) PIVs?
# of staff nurses (or other personnel placing lines):
What type of lines are placed?
Service Hours:
Cost of PIVs placed by IV team versus staff nurse:
How do you determine nursing staff requirements (bed versus sticks per each nurse, etc.)?
Is there a metric used?
How does your facility justify or balance (budget)?
Neutral or Central Staffing (CSO)?
Does your organization track SVT/DVT associated with ultrasound PIVs versus traditional PIVs?
Use of early assessment tool to determine which IV access is appropriate?
Comments:
Thank you in advance for any feedback provided. CH
No answers to your questions but I strongly applaud your efforts. I would recommend that you also investigate how your team is set up from a budget standpoint. Is your team a cost center or a revenue center? If you can possible change to a revenue center, you will have a better chance of survival. Revenue will come from outpatient procedures. So if your team is inserting VADs in that setting, billing is different and does not come under a capitated fee structure. So the revenue from those outpatient procedures is credited to your department, so it is possible for your dept to become a revenue producer! Good luck with your efforts. 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
That seems to be the trend now. I've noticed it across two big hospital systems now. We, as nurse driven services, are not doing ourselves any favors with PIV's. First to be successful placing PIV's using US you must have a good amount of experience on image identification and needle to vein contact. Too many folks are just grabbing the machine and sticking. What we are seeing , enought to be a problem, is a gross tissue infiltrate because they did not have good purchase on the vein. I truely believe, and yes I am aware of others objecting to my theories, that the PIV should be for a limited purpose. But they still, in 2016, are the most used and abused line in the industry. Everyone is scared to death over the big CLBSI threat. I get it. But has anyone done a study where normal Midlines and Picc's are used and care and maintenance is really scrutinized? I bet CLABSI rates can be "zero" with a powerful stance on care and maintenance. Instead we use a scattershot approach and almost religiously avoid what would really work?
So, yes I see PICC teams that should be moving toward Vascular Access Teams doing Midlines, PICC's IJ's Axillaries, ABG's ...maybe CVC's in the ICU,.....moving toward glorified IV teams. Sad state of affairs.
Jack