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Observer RN requirements

I seem to recall 5+ years ago requirements were hit or miss on an observer RN at bedside to ensure checklists were being completed as part of CVC bundle. My question is can someone direct me to actual evidence based or guidelines on the actual requirements? Was the requirement for two picc nurses and this faded as cost cutting measures shrunk teams and most were operating alone? I keep going back to the observer role was a CDC recommendation.  In the event a facility was struggling with CVC placement related CLABSIs and they had implemented all of the CDCs best practice guidelines, as a last resort put an observer in room. Am I correct? Thanks in advance for any input. I'm struggling to find any evidence to support yay or nay.

Stay healthy. Thanks!!!

Greg S. 


Not quite correct. The

Not quite but close. The guideliens and standards call for completion of a checklist to ensure all steps were done and there was no contamination during all CVAD insertions. The inserter cannot do this checklist after the procedure because one cannot observe ones self. Thus an assistant is needed to help with set up and clean up, meet patient needs during procedure and observe procedure to complete the chekclist. This person is also empowered to stop the entire procedure if there is any breach from that checklist. See 2011 CDC guidelines, 2014 SHEA Compendium on CLABSI, now in revision, and 2021 INS SOP. This person can be a UAP like a CMA or CNA that has received specialised training in this role. There is no requirement that this be another inserter or even another nurse, but someone trained to do the job. 

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Thank you Lynn!!!

Thank you Lynn!!!

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