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LoisRajcan
Percentage of Bedside Piccs sent to IR

As a new PICC team (10 months) using USG needle insertions, we referred 30% of our bedside Picc calls to Interventional Radiology.  That means we did 70% successfully at the bedside with out a Picc tip locator.  I am interested to know what the national averages are and if we need to improve on these numbers.

lynncrni
Most nurses report greater

Most nurses report greater than 95% success rate with the use of US and MST. Maybe your numbers are low because you are still going through your learning curve. It also could be that you are not identifying patients early enough in the course of their treatment, leaving veins totally wasted before you even try.

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

www.hadawayassociates.com

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

kokotis
Kathy Kokotis Bard Access

Kathy Kokotis

Bard Access Systems

Lois

How many PICC lines have been placed with ultrasound to date?

How many RN's did you train to use ultrasound in ten months

How many insertions did each get to do in ten months

Are these RN's dedicated full time to PICC line insertion or are they working other jobs and do PICC lines in their spare time or in between peripheral IV's and dressing changes?

The learning curve for ultrasound is 50 insertions each to be at 90%.  I am concerned when you say that you are at 70% in ten months.  In ten months the learning curve should be over so something else is up.  How much training and precepting did you get on the usage of ultrasound. 

Answer the above and I can offer better advice to meet your needs

Kathy

Kathy Kokotis

Bard Access Systems

Leigh Ann Bowegeddes
Agree with Kathy and Lynn.
Agree with Kathy and Lynn. We are mostly an experienced team, with one new member in the last 6 months. We refer 1.5% of our patients to IR, and this is because the catheter won't advance to SVC, requiring fluroscopy. If we cannot access the vessel in the arm, the pt requires another type of access, as IR is not going to be more successful at access than we are.
LoisRajcan
Kathy: I was concerned too

Kathy:

I was concerned too about our numbers.

In 2007, We had 413 Successful Picc insertions...this means into the SVC. We Had 584 candidates.  We began USG picc 3/07.

We have 2 nurses on day shift and we are required to do all IV calls, dressing changes, Port accesses, Cathflo and sometimes chemo administration.  4 nurses are trained only 1 nurse is full time the rest are part time.

We do 10-16 IV starts in one day and 3-5 Picc referrals.  Dressing changes range from 3-8 in a day. Port access and Cathflo can be 1-2/ week and Chemo is 2-4 times a year.

Training included 2 days with a Bard RN Picc educator/representative to show us the ultrasound machine and each of us did 1-2 picc lines.

Originally we trained on a hand me down Site Rite 2 and the battery lasted only 10 minutes and the view was difficult.

The hospital then budgeted for a Site Rite 6, we had a great sales rep from Bard who lended us the sales machine, but it would have to be taken from us to do a sale at another hospital.

Officially, we have our own Site Rite 6 in October 2007 after much inconsistency.  

I believe that comes into play with our numbers too.  I have seen a much more success rate since we have our own Site Rite 6 in October.

Leigh  Anne:  I think we are often referred Picc lines on patients that are not candidates, and their vascular system is difficult due to age, and disease process.  I believe that is also come into play.  I do appreciate your input on this.

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