We started placing midlines approx 2 years ago. Our goal was to have an alternative IV access device for pts when no access was attainable yet a Central line was not indicated.
We have had great success at doing such. Now , mind you, corporate was pushing for everyone to get a midline and not a central line to keep the CLABSI numbers down. We have not used the midline as a replacement for a central line, but utlize it when it is whats best for the pt, not whats best for our numbers or potential numbers. In doing so we have actually added a larger pt group to our workload, as there are many more pts who benefit/need a midline that we were not involved with when inserting only PICC lines. So....on that note.... $ $$ wise we ended up spending more since purchasing many more midline kits, in addition to a lesser quantity of PICC Line kits.
yes, once we mastered the art of free handed midlines we also do us guided ivs. i did needle guide picc lines so long, it was very hard for me to get a line using ultrasound without the needle guide.
We have found that when using us for iv starts it is bette to use the longer iv caths, such as the extra 1 3/4" iv in the kits .
Because some pts dont even really need a midline , a peripheral will do..
the problem we see now Ken, is the the increase in Midlines presents a whole set of problems. IMO, a Midline is a catheter designed to replace the peripheral. NOT to replace a PICC. It's a strange situation we are seeing now that I for one DON'T agree with. Get the central line out replace it with a Midline . In short, Midlines will not meet the needs that hospital admin think it will.
So, that means bad access more sticks. So, it's not a good trend, however, I'm afraid a trend that will continue. But purely for infection prevention. Infections occur the same was as a PICC so why the change?.....follow the money
No midlines , about 700 piccs a year
Jenn
Why no midlines?
FY 16-17 688 PICCs and 181 ML; FY 17-18 601 PICCs and 93 ML
Aileen Rogers RN VA-BC
Aileen Rogers RN BSN VA-BC
IV Team Resource Nurse
Thanks
We started placing midlines approx 2 years ago. Our goal was to have an alternative IV access device for pts when no access was attainable yet a Central line was not indicated.
We have had great success at doing such. Now , mind you, corporate was pushing for everyone to get a midline and not a central line to keep the CLABSI numbers down. We have not used the midline as a replacement for a central line, but utlize it when it is whats best for the pt, not whats best for our numbers or potential numbers. In doing so we have actually added a larger pt group to our workload, as there are many more pts who benefit/need a midline that we were not involved with when inserting only PICC lines. So....on that note.... $ $$ wise we ended up spending more since purchasing many more midline kits, in addition to a lesser quantity of PICC Line kits.
Here are our totals this year so far.
393 PICC lines inserted and 939 Midlines inserted so.... 42% Piccs/58% midlines
by the way we are a 110 bed rural hospital
Thanks, Gina Ward R.N, VA-BC
Gina Ward R.N., VA-BC
Thanks Gina,
Do you guys place any ultrasound guided IVS?
yes, once we mastered the art of free handed midlines we also do us guided ivs. i did needle guide picc lines so long, it was very hard for me to get a line using ultrasound without the needle guide.
We have found that when using us for iv starts it is bette to use the longer iv caths, such as the extra 1 3/4" iv in the kits .
Because some pts dont even really need a midline , a peripheral will do..
Gina Ward R.N., VA-BC
the problem we see now Ken, is the the increase in Midlines presents a whole set of problems. IMO, a Midline is a catheter designed to replace the peripheral. NOT to replace a PICC. It's a strange situation we are seeing now that I for one DON'T agree with. Get the central line out replace it with a Midline . In short, Midlines will not meet the needs that hospital admin think it will.
So, that means bad access more sticks. So, it's not a good trend, however, I'm afraid a trend that will continue. But purely for infection prevention. Infections occur the same was as a PICC so why the change?.....follow the money