I have never worked where an order to use was required. Now most nurses inserting PICCs are actually doing the initial assessment of tip location on the chest xray or using ECG. Both of those situations would have the nurse inserter making this assessment, so no additional order from the physician is required. If we are inserting and using this technology, why are we not capable of saying the PICC can be used for infusion? this simply does not make sense to me, although I am sure that some facilities restrict nursing practice in this way. Lynn
A "Line Okay to Use" order must be in placed only after initial PICC confirmation. We use a Vascular Positioning System (VPS) by Arrow. If we ordered a chest x-ray to confirm placement, the doctor follow up the radiology report and places the "Line Okay to Use." If we confirmed by placement using VPS, Vascular Access Specialist will write the order. The confirmation from the VPS, is electronically transferred into our electornic documentation.
I'm not quite sure why policies say that an MD must say it's OK to use?. Especially Radiologists. In my experience, Radiologists seldom agree on placement. One may read "at CAJ" then another could look at the same film and say "short" or another say "into right atrium please retract 5cm"...I think we,as vascular access nurses, are pretty consistent. So, I have always pushed to let the inserting nurse call the position. And always remember, (so you can tell those that say we can't read) we are NOT reading an X-Ray we are simply identifying placement of the PICC.
I have never worked where an order to use was required. Now most nurses inserting PICCs are actually doing the initial assessment of tip location on the chest xray or using ECG. Both of those situations would have the nurse inserter making this assessment, so no additional order from the physician is required. If we are inserting and using this technology, why are we not capable of saying the PICC can be used for infusion? this simply does not make sense to me, although I am sure that some facilities restrict nursing practice in this way. 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
A "Line Okay to Use" order must be in placed only after initial PICC confirmation. We use a Vascular Positioning System (VPS) by Arrow. If we ordered a chest x-ray to confirm placement, the doctor follow up the radiology report and places the "Line Okay to Use." If we confirmed by placement using VPS, Vascular Access Specialist will write the order. The confirmation from the VPS, is electronically transferred into our electornic documentation.
I'm not quite sure why policies say that an MD must say it's OK to use?. Especially Radiologists. In my experience, Radiologists seldom agree on placement. One may read "at CAJ" then another could look at the same film and say "short" or another say "into right atrium please retract 5cm"...I think we,as vascular access nurses, are pretty consistent. So, I have always pushed to let the inserting nurse call the position. And always remember, (so you can tell those that say we can't read) we are NOT reading an X-Ray we are simply identifying placement of the PICC.