My CNO wants references as to why I'm requiring labs (CBC, CMP, PT/INR) prior to placing a PICC. Does anyone have any besides what is on this site (sample P&P, competency checklist)? Are you even doing labs (if you aren't, do you have references for not doing them too)?
I'm a one man "PICC dept" (I do have a PRN person that rotates call with me), I work in Radiology, place all PICCs (30-45/monthis our avg), do stress tests, assist with biopsies, help at the desk and wherever else I'm needed in Radiology, start IVs, do film copies for legal firms, ohhh and I'm the facility resource coordinator (a supply/materials management thing) for the hospital.
and just to throw my two cents in....... I agree with no such thing as a STAT PICC, if it's needed that bad, a physician can be placing a line quicker. I do get called in at night and weekends for PICCs, but will tell them I'll do it in the morning if it's too late.
anyway, QUICK answers are REALLY appreciated, I need to answer the CNO
I've only been placing PICC for about 5 months. At our hospital we have a policy and procedure that clearly states a pt is NOT a candidate for a PICC line if their platelet count is less than 50, INR greater than 3.0 or PT greater than 38. I carry a copy of this policy around with me. I have referred to it multiple times. I found that neither the MD or the nurses are looking at recent lab vaules before sending request for placement to me. As a new PICC nurse, this policy has help support me on pt's I felt were at risk for increased bleeding upon insertion.
Just to update on this subject as far as my hospital is concerned:
couldn't find any written references that states labs must be taken into consideration, though most will say to review labs/coagulation studies. So the CNO has opted to remove the requirement for labs prior to placement from our policy. Thanks for the couple of posts that were made.
Lawrence Rojas RN
Radiology Dept.
Garden Park Medical Center
Gulfport, MS
Lawrence Rojas RN
Radiology Dept.
Garden Park Medical Center
Gulfport, MS
We placed a PICC in a patient with platelet count of 9 yesterday, no bleeding at the site. We are using a tapered catheter. There was not any bleeding.
We have placed PICCs in patients with INR >5 without any problems. We use a tapered catheter and find that there are no problems.
We find that a PICC is the safest option for these patients. We have not encountered problems with the insertions that indicate this is not the safest option.
Questions? Please let me know.
Gwen Irwin
Austin, Texas