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That sounds like "because we've always" or "we never" kind of thinking.  I can't speak for your hospital, but generally - there is no reason a staff RN with competency in care and maintenance of a double lumen PICC couldn't care for a triple lumen PICC.

Staff and MDs should provide the same type of assessment every shift, and every catheter use, for a triple lumen as they do a double lumen. 

Mari Cordes, BS RN 

I believe that the CDC guidelines should be followed. The fewest lumens that accomplish the therapy ordered.  We also teach scrub the hub, but if the patient doesn't need a triple any longer (and most don't), we will ask for an order for the exchange to a dual or a single.

We are trying to follow all triples inserted in the ICU, when transferred. We are advocating for an exchange.

Gwen Irwin

If you're doing daily assessment of line needs, ideally you wouldn't have to remove or exchange a line because the staff that you're sending the patient to isn't educated.  Even if it's a cordis.  Cordis' are short term catheters and should be removed promptly and as soon as the best vascular access option is in place before the cordis is removed.

If, whether they are in an acute care unit or the intensive care unit, the daily line assessment determines that the patient should have a different type of access, we will provide that different access.

Also - because we do a very thorough preplacement evaluation, including being able to measure the diameter of the blood vessel to the hundredth along as much of the length of the vessel as we can ultrasound, we will choose the right size catheter for that vein.  If a triple lumen is not appropriate - we won't insert one.  We also support the best practice of keeping any catheter exchanges to an absolute minimum (though understand sometimes it's the best choice).

I know education is a challenging issue.  Our facility is large, and our nursing administration is very protective of how much the nursing staff are presented with at once (because they are constantly approached by different departments and specialties with new implementations).  Ideally, however, I think the goal should be that all staff that handle vascular access devices should be current and competent in the best practices/standards of practices for care/maintenance. 

Mari Cordes, BS RN 

There should be no reason that would prohibit a patient with a triple lumen PICC from  being transferred to a med-surg unit with that catheter. This is virtually no different than a triple lumen nontunneled, percutaneous CVC. Cordis is a brand name for an introducer for a pulmonary artery catheter. It has an extremely large lumen and there is a much greater risk of air emboli or exsanguination if the connection becomes loose. So it is never advisable to send those outside of the critical care setting. 

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

www.hadawayassociates.com