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DonnaS
Bedside PICC insertion exclusions
Was wondering if anyone has specific exclusion criteria for bedside insertion?
Dava Brown
Donna, we have an
Donna, we have an indication/contraindication policy that I will share if you provide your e-mail address.
Nancy Crouch
Dava'   I would like a copy
achoosa1
Hi Dava, Could you please

Hi Dava,

Could you please give me your info regarding an indication/ contraindication policy as well? My email address is [email protected]

 Your help is greatly appreciated.

 

Jenn M.
Dava, I would love a copy of

Dava,

I would love a copy of your policy as well.  My institution's policy does not include contraindications.

Thanks in advance,

-jenn

[email protected]

Sally Walker
Dava- Would you be willing

Dava-

Would you be willing to send your indication/contraindication policy to me?

[email protected]

 

Thanks.

Sally 

IVINFUSIONS
Hello Dava, I would really
clhunchusky
Dava, Can I get a copy of
sdorting
Exclusion criteria policy
kevinmcl2003
PICC contraindication policy
michael2010
picc policy
Louise M
Starting Business Case for Nurse PICC Team

Hi Dava, May I please have policy of indications/Contraindications?

Also, some nurses I work with are concerned about infection control risk of inserting at bedside. Are there any journal articles on this topic?

DonnaS
Thanks Dava, My email is

Thanks Dava,

My email is [email protected]

Joey Miller
i would like a copy of that
i would like a copy of that also if you don't mind sharing.  We have a new PICC team and are still trying to work through some of the bugs.  Thanks!  My email address is [email protected]
mary ann ferrannini
Are you talking about
Are you talking about medical contrandications such as bilateral mastectomy or just reasons why bedside placement would be impractical ? Or maybe both. The only impractical reason would be that we can not get the patient to cooperate. They could be combative or abusive or spitting at us. We tend to send those down to IR so they can be medicated,and I am glad to comply!!!! 
DonnaS
Dava, Not sure if you sent

Dava,

Not sure if you sent the email with the policy or not.  Just wanted to make sure my email didn't fail.

Thanks!

rivka livni
In our intitution I met with

In our intitution I met with Infection Control, Renal Services, and Oncology services.

We do not insert a PICC if blood cx are positive and until we see at least 2 days of negative survalience blood cx.

Every patient with blood createnine greater the 2.0 must be approved by Renal service for PICC insertion.

We do not insert in Mastectomy with lymph disection on the affected side.

When it is end of life comfort care - we do a PICC where ever we can find a vein.

RoseFeltner
Dava, Can you please send me

Dava,

Can you please send me a copy of your policy for contraindication.  I need to educate some staff and MD's on when a PICC is not the best choice and could use all the help out there.  If anyone knows of specific articles please forward those also.

Rose

[email protected]

asherwood
At the intitution I work at
At the intitution I work at we have a policy on laboratory values that have to be met before PICC placement. They are: INR has to be less than 3, Platelets must be above 50, and PTT less than 80
RoseFeltner
Asherwood,   Can you please
lynncrni
I would think that these are

I would think that these are the very patients where a PICC would be the safest type of vascular access. So rather than prohibit placing PICCs in these patients, I would prefer a PICC over using the IJ or subclavian veins. 

 

Lynn Hadaway, M.Ed., RN, BC, CRNI

www.hadawayassociates.com

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

pjean
Dava, Would appreciate a
mavian21
Can you pls. suggest
Can you pls. suggest websites or articles/journals  where I can obtain some information re: inserting bedside PICC's on patients with pacemaker( contraindications if there are any and complications of inserting PICC's on the same side where the pacemaker was inserted). I had browsed through google... there were only a few topics which did not give a lot of information about my inquiry. Thanks !
afruitloop
I had looked for this
I had looked for this information a year or so ago and couldn't find much.  I spoke with an IR physician that was active with AVA regarding hsi pratice.  It made sense to me, thus the facility that I worked at adopted this practice.  If the device was less than 30 days old, the PICC was not placed on that side, but if it was > 30 days, it was.  The theory here was that the device leads were encapsulated in fibrin, thus decreasing the risk of the catheter device entwinment (is that a word?)

Cheryl Kelley RN BSN, VA-BC

JoseDelp
I agree with Lynn here.

I agree with Lynn here. I do not have apolicy that sets parameters for not placing a PICC when coags are off. We feel those patients are sick and in need of reliable safe access as soon as possible and we feel the PICC is the safest route in those situations. We take extra precautions to decrease bleeding and bruising in these patients. 

Jose Delp RN BSN

Clinical Nurse Manager IV Team

Upper Chesapeake Health

Jose Delp RN BSN

CliClinical Nurse Manager IV Team

Upper Chesapeake Health

paul
Cheryl, One should be

Cheryl,

One should be careful with placing a PICC in the same arm where a Pacemaker or ICD has been implanted. Most subclavian veins have narrowed over time around the indwelling leads. This results in a higher degree of difficulty in passing the catheter through the vessel. Also, Midline placement may instill IV fluid into the device pocket. This may cause a device pocket infection. These wires or leads are stiff and fine and could cause shearing of a catheter with placement and/or removal.  

Paul Howell

janeterick
I am interested in a copy if
I am interested in a copy if the policy also.  My personal e-mail for correspondence is [email protected]

Janet Erickson

Gina Ward
Gina Ward R.N.,

Gina Ward R.N., C.P.A.N

 www.firstdonoharm.com

This web site has an EXCELLENT  video on it from Cheryl Kelley R.N, !! 

It discusses many aspects of picc insertion.  I must say this is the most informative piece of information I have found on PICC lines in the last 4 years. 

I took 5 pages of notes on it ( front and back).  It helped me develop a pre assessment tool prior to putting in lines ;  starting with assessing the reason, the patient hx, choice of lines, precautions, contraindications, vein assessment etc.    I cant brag enough on it!!

Hope this helps,  Gina Ward R.N., CPAN

 

Gina Ward R.N., VA-BC

Louise M
Do No Harm video

Hi Gina,

I can't get the video to work. do i need to join or click on something?

Gina Ward
do no harm video by Cherly Kelly

 

I went to the website and opened it up.  It has some pop ups and as you try run the video and it does not run look at the bar on the top of your screen, it tells you to open up something or "allow" something to run to be able to watch the video.

 

hope it helps,  Gina

Gina Ward R.N., VA-BC

rozalindej
Hi Dava, Can I please have a
rmcbeath
Dava, can I also get a copy
deedee
Dolores Tinker CRNI Hi

Dolores Tinker CRNI

Hi Dava

Can also get a copy of your policy

Thank you

[email protected]

Dolores Tinker CRNI

amorrow
Dava, I'd like a copy of

Dava,

I'd like a copy of your policy as well.

Thanks,

Amy

 

kunzerod
Exclusion criteria policy

Rod D. Kunze RN, RCIS Action Site Manager, Door 2 Balloon coordinator PICC coordinator St Vincent Healthcare 1233 North 30th Billings, Montana 59101  Work    (406) 237-4300 FAX      (406) 237-4390 Beepe

M00513
Dava, May I please have a

Janet Eckard

michael2010
picc policy
davica
Exclusion criteria

 our Policy states that in order to get a picc a pt has;

To be getting TPN for greater than 3 days-Must have nutrition consult that supports need for TPN

Ab Rx for >7 days

or complex Medical conditions

However... GFR must be >30 for PICC. If Gfr is low then a PICC may be placed by IR in IJ -- typically tunnelled subclavian cath --if other criteria met

MD must consent Patient

No Blood cultures drawn or must be neg for 48 hours before insertion

No lab draws from PICC unless lab is unsuccessful x's 2 people who try twice

4 french only is the choice cath unless TPN or Multiple incompatible meds.

 

Tracy Snashall
may i also have a
kathykokotis
Exclusions

I love it when there are anecdotal exclusion criteria

Suggest one does a research project of the literature before taking anecdotal commentary from this board on exclusions that may or may not be evidence based

This would make a great topic at a conference as to what are the real published exclusion criteria.

kathy

Louise M
CN Rates

Do RN picc inserters get paid as level 2 in Qld?

Denise Harris
PICC Policy

Hi Dava,

 

We are also updating our policy, I would love to see a copy of your policy.

 

Thanks,

Denise

 

DHarris

Random VAT person
would love a copy also

thanks!

David

dianesuter
Dava-list of indications and contraindications

Diane Suter, RN, VAT
SAVAHCS

MarkCVL
Might be easier to post in

Might be easier to post in the "Resources" section.....Less headache to re-post each time!

kmills
PICC Line Contraindications
kathykokotis
contraindications

Best article:

Ryder, Marcia  Nursing clinics of North America 1993  on PICC Options - still holds today.  One of the best articles ever written on PICC lines

The article also has contraindications for subclavian and jugular access as well

See your manufacturer instructions for use as well

Kathy Kokotis RN BS MBA

Bard Access Systems

RichL1
Please add me to list

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