We place a little over 100 PICC's/month.Â About 8 to 12 of these are outpatient.
Our docs wrote "guidelines"(JCAHO driven?)regarding outpatient procedures.Â One
of these was that any outpatient receiving an invasive procedure-including central
lines, had to have a recent-(within 30days with an update within 7 days-History and Physical.)
Â Now they are unhappy they have to write H&P's when they send patients in for
PICC Placement because we insist on a recent H & P.Â The latest thing they've done
to get around that is to state that PICC placement is not an invasive procedure and
therefore doesn't require an H & P.Â The nurse who keeps us all adhering to JCAHO
(I'm not sure of her title)now says that if it is not an invasive procedure, we don't
need to get a written informed consent for it...not for inpatients or outpatients.
Â I know the docs in our hospital have a lot of power, but am apalled to think they may
be able to decide unilaterally what is and what isn't an Invasive Procedure.!
Â Has anyone heard of anything like this before?Â Are you all required to get some kind
of informed signed consent?Â Â Â Where does this put our PICC nurses from a legal standpoint?