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Elizabeth Defina
Daily needs assessment for central line
Does anyone have a sucessful daily assessment for the need of a central line? Do you document need daily? What criteria (if any)does the bedside nurse use to suggest the removal of the line to the MD? Any help would be greatly appreciated.
Our department came up with

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

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. 



Nancy Rose 

The PICC should document as
The PICC should document as a central line...we also have a daily Central Line progress note which requires a reasoning for continued line use.We do not reccomend that a PICC line be used for TPN and Abx -due to the increased risk of line infection with multiple breaks in the line.The PICC should be dedicated to on or the other...unless the line you are using has multiple separate lumens.Why would you pull a perfectly good PICC just to put in a peripheral IV? This doesn't make any sense.
Elizabeth Defina
We are trying to remove
We are trying to remove central lines ASAP to eliminate the risk of infection, so if a peripheral site can do the job we would prefer to remove the central line. Plus I do believe it's a NPSG thanks
The IV team rounds daily on

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

Jose Delp RN BSN

CliClinical Nurse Manager IV Team

Upper Chesapeake Health

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