At my full time job we place PICC lines using one RN to place the PICC and one to circulate during the procedure, at my previous job, we did this the same way. I have recently started a 2nd job at a small (74 BED) hospital and they do not place very many PICC's monthly, maybe 20, when they place a PICC, they use a two nurse procedure, but the procedure consists of one nurse setting up the sterile field, using the ultrasound to access the vein, stablizing it, placing the dialator in the arm, THEN, the second RN takes over and places the catheter. I have NEVER seen anything like this and when I asked what the rationale behind this is, I was told that since they dont place that many PICC's, it helps to keep the skills up for both RN's......... I am unfamiliar with this and frankly, very uncomfortable with it. I certainly do not want to work off of another RN's sterile field, if I did not set it up, I cannot guarentee the integrity of it, nor do I want to place a PICC in a vein that I did not decide on myself. Has anyone heard of this, do you do this in your practice. I have the INS evidence based book with me and the only thing I can find is a small blurb that states
"When two nurses are working simultaneously at the bedside, the second nurse can be setting up supplies on the sterile field, providing support for the patient, and assisting when needed to access the vein, insert the wire, or thread the catheter."
Does anyone know where I can find evidence supporting this either way? I cant imagine this is best practice, I would really like to know.