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Denise Doscher
CLIP form

 

 I own a Vascular Access company, I have always used the CLIP (Central Line Insertion Practice) form from the CDC and leave it with the patient's chart after placing a PICC, I was recently informed by a PICC team manager that if I have a time out and other information on my paperwork, I do not need to fill this CLIP form out.  Does anyone know the requirements on this form? Thanks,

Denise Doscher RN, VA-BC, CRNI

PICCsmart

 

lynncrni
You are talking about an

You are talking about an insertion checklist that is the standard of practice for all CVAD insertions. According to SHEA, CDC, INS, this form should be completed during the procedure by an empowered observer who is trained to recognize deviations and can stop the procedure if noticed. The PICC team manager is wrong. The facility can decide if this form becomes part of the permanent record or if it goes to infection prevention but the other paperwork you mentioned does not replace this insertion checklist. 

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

Denise Doscher
CLIP form

Thank you Lynn, just want to clarify, the CLIP form that I print from the CDC site, list patient name/dob/ethnicity/race, facility type, my information such as name/title and it ask type of device, sterile items used, device type, skin dry at insertion, did this result in sucessful insertion etc.  Is there another form that I should be using and if so, do you have a suggestion or can you direct me to one I can use.

Thank you so much,

Denise Doscher RN, VA-BC, CRNI

PICCsmart

 

 

 

Denise Doscher RN, VA-BC, CRNI

PICCsmart

[email protected]

800-324-2835

lynncrni
The one you are describing is

The one you are describing is probably the original one, but others have made their own form. As long as the important steps are included, the form itself does not matter. The point is a tool that will document that all steps for asepsis and safety were done correclty. 

 

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

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