Our department came up with a daily central line assessment form that our IV team uses when we check central lines everyday. We look at the current medication, speak with the assigned nurse regarding the plan of care, look at the progress notes of the physician, and look at the peripheral veins of the patient. We document the need daily and it could be chemotherapy, meds, TPN, long term abx., etc.
Many times patients receive a PICC for TPN and abx. Once the TPN has been discontinued, the patient may have adequate access for a PIV so we suggest pulling the line.
We will also leave notes in the chart for the physician suggesting pulling the line.
Nancy Rose RN IV Team VA Medical Center Wilmington, DE (800) 461-8262 ext 4830
Our physicians document need. In our electronic chart when physicians write a progress note the question, "does this patient have a central line?" pops up. If yes, they must choose from "reason for central line" 1. TPN 2. lack of reliable peripheral acccess 3. vesicant drugs.
The IV Team assesses daily need as well and suggests removing central lines. Sometimes, the progress note documents "no" central line when there is a PICC.
The IV team rounds daily on all central lines and assesses continued need for the line. We participate in ICU interdisciplinary rounds daily and police the continued need for the lines there as well. We do not formally document the need unless it is femoral and then document why it cannnot be moved etc as needed.
We have a report that prints daily at 0500 that tells us who has what lines.
Jose Delp RN BSN
Clinical Nurse Manager IV Team
Upper Chesapeake Health
CliClinical Nurse Manager IV Team