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Greg Scott
Bedside RN discontinuing PICC

I am searching for support, one way or the other, as to who should removed PICCs.  I work for a very large hospital and we have a very small team.  What are other PICC teams doing?  My manager wants us to remove the PICCs, but I don't see this as being possible with only 2 FTEs for PICC placement.  We could not ensure timely removal.  Is this validation for more help?  Thank You.

lynncrni
 It certainly should be a

 It certainly should be a part of any proposal for additional staff. The professionals given the responsibility for removing a PICC must meet the same standards of practice as established by the Infusion Nursing Standards of Practice. There must be competency documentation for all who do this, including techniques, what to do if venospasm is encountered, what not to do, etc. Do you have the staff for that process? Also, does your team ever see PICCs ordered to be D/Cd, you don't agree with that and discuss with the physician and the order gets changed for whatever reason? If so, the staff nurses would not have the knowledge to do this assessment and discussion. Someone in your facility should be assessing all CVADs for possible removal on a daily basis as this is now part of the recommendations from CDC, INS, IHI, etc. Who is doing that? Lots of questions to answer to determine if this is right for your facility. It all comes down to who is competent to do this procedure and all nurses can become competent. You will need a policy and procedure for removal which should include who can do it. Lynn

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

Glenda Dennis
A possible consequence of

A possible consequence of unskilled PICC removal is air embolism with potentially devastating results to the patient.  It is rare and published data is scarce but should be carefully considered.  This is not a slam dunk kind of procedure.  I agree with Lynn that the PICC team really needs to be doing this procedure with documented competency. 

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