I am a PICC RN and my facility has just agreed to allow me to trial Bard Power PICCs on select patients.
So far two have been placed here, and I have worked with two other lines placed outside of the hospital.
I was also assigned the tedious task of updating our hospital IV therapy policies to adequately reflect nursing care regarding Power PICC lines. Before we exclusively used groshong PICCs.
Two questions:
1. What flushing technique is best used with Power PICC lines. We use positive-pressure central line caps. Should we flush, detach syringe, then clamp line? Or is it flush, clamp as last ml instilled, then detach syringe?
 2. Should a heparin flush be routine policy with the maintenence of Power PICCs? It was very simple for floor RNs to know prior to this-- with PICCs saline only! Now I am not sure what to tell the floor RN when asked. I find myself saying, if you are using the line frequently, no heparin is required. But I cannot assess each individual patient for the frequency of use of their line as IV orders change and patients progress to being on oral medications. A standard policy on proper Power PICC flushing needs to be in place, and I find the printed material in the Power PICC catheter trays to be too nonspecific to incorporate into our hospital guidelines.Â
Any feedback would help! Thanks.
-Caren
IV/PICC RN
For flushing through all positive displacement needleless connectors, regardless of the type of catheter they are attached to, the procedure is always flush, disconnect, allow a few seconds for the fluid displacement to occur, then close a clamp on the catheter. Closing the clamp prior to this will prevent the fluid displacement from occurring on valved and valveless catheters.
Regarding use of heparin - what are the instructions from the manufacturer of your brand of positive displacement connector? Some state saline only and some do not. So check those instructions. If they state saline only is required, you do not have to change your policy. If they do not make a recommendation about saline only flushing, then you will need to use saline followed by heparin after each use of the catheter. There are no studies that state to omit the heparin if there is only XX time between uses.
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