For bedside procedures such as PICC insertions, what is the requirement for the presence of patient's nurse during the procedure once the Time Out is obtained? Is the patient's nurse required to stay in the room for the entire procedure or may they be outside the room, yet readily available? Can a medical assistant be used instead of a RN?
Any CVAD insertion, including PICCs, should have an extra person helping with the time out, and more importantly trained to monitor the entire procedure and complete the checklist as the procedure progresses. As stated in the SHEA CLABSI Compendium and now the INS Standards, the person completing the checklist can not be the inserter. This person is needed during the entire procedure and it does not have to be the patient's primary care nurse or even and RN. This assistant can be an unlicensed person trained in what their role is and what they are observing. 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
The key elements/tasks the personnel in the room are needed to do is:
1. The time-out
2. assist with securing the inserters sterile gown.
3. monitor the sterile field
4. stop the procedure if checklist is not followed or sterile process is broken, correct the infraction and allow the procedure to continue.
5. Assist with obtaining the image of real-time needle entry into the vein for CPT Code 76937 compliance, if needed.
6. obtain needed supplies or equipment if the need arises.
See INS SOP 2016; Standard 33,III,B
R. Terry Jones, RN, CRNI, VA-BC
Memorial Hermann Northeast Hospital
Humble, Texas