We have been having a lot of issues with our PICC's recently. Our facility typically uses only groshong PICC's. When they are inserted, there is a very large portion of the external length (averages about 10 cms, and have been much longer than 10 in many cases). When dressing these, the nurses have been experiencing many difficulties. Stablizing the catheters is difficult, and statlocks do little when they are this long. We have been coiling the piccs to help secure them. While dealing with such a long catheter, we have concerns about sterility and causing BSI's as there is a lot of manipulation of the catheter to coil and stabilize it, as well as measuring the external length, it's difficult when it is so long.
Is this the norm? If not, can someone point me in the direction of evidence to support shortening the catheters? We've talked to radiology who inserts them, and they just say "too bad, we won't change" without any rationale.
Thanks
You must be referring to dual lumen Groshong PICCs. These can not be trimmed to a patient specific length because of the valve on the internal end and the fixed extension legs for each lumen on the external end. Single lumen Groshongs can be trimmed to length on the external end, however the hub must then be assembled at the bedside. Changing catheters so that you can have a trimmable device is the only way to decrease this excessive external length. Lynn
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
Thanks for your reply,
We are using primarily the single lumen groshongs, but are facing a refusal to trim them to a more appropriate length. I am hoping to find a way to convince them that trimming would be best for the patient. From what I've seen, we are risking BSI's with handling such a long length of catheter.
There is no excuse for not trimming a single lumen Groshong! Well, maybe just be too lazy to do it!! Have you contacted the company for their support? Lynn
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
Thanks! I felt the same way about it :)
I will contact the company, I don't know why I haven't thought of that sooner.
External length can be properly managed when the RNs are educated regarding care. This is something that must be done at least every 6 months due to turnover. This care is not something that is taught in nursing schoool and is typically guessed at or passed along nurse to nurse. Many times, the manufacturer has clinical support that can help provide this education at no cost to you. By the way, there are no published studies that show an increased risk of infection related to external catheter length.
Chris Cavanaugh, RN, BSN, CRNI, VA-BC