We allow staff nurses to pull lines here, but I wish we didn't. We do however competency theses nurses yearly, but they still do not do it often, so what you do not do a lot, you sometimes forget, and that scares me. I have seen some pretty scary things around here, and some that make me go HMMMMMMM....... what were they thinking???? I like the idea of the ICU and IV nurses doing it. I may attempt this. Wish me luck.
I think you have a valid concern about things not frequently performed. CVC removal appears to be a benign procedure, however I have been the expert in several lawsuits about serious complications occurring from CVC removal.
Lynn, may I be so bold as to ask what the complications were? Just curious because I would also believe my staff to be well-trained but now wonder if there are other considerations I should discuss or emphasize.
Parodoxical air emoboli, meaning that the air went to the brain causing severe brain damage. Patients now living in a nursing home unable to care for themselves. The issues are what constitutes an "occlusive" dressing - TSM with gauze and ointment or gauze & tape with ointment. No clear definition on dressing material, but no question that ointment is necessary to seal tract. Also, how long should be patient be required to remain flat after removal. I have found 3 references - 1 hour, 30 minutes, 10 minutes but none are evidence based, other than professional opinions. Lynn
This would be the same as any other CVC and is done by nursing with documented competency in the procedure.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
Lynn Hadaway, M.Ed., RN, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
I agree thanks for the response, people's reactions have differed greatly.
Blanche
Our critical care RN's will pull femoral lines after they complete the competency.
Mike Horrigan RN
I think you have a valid concern about things not frequently performed. CVC removal appears to be a benign procedure, however I have been the expert in several lawsuits about serious complications occurring from CVC removal.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
Lynn Hadaway, M.Ed., RN, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Lynn, may I be so bold as to ask what the complications were? Just curious because I would also believe my staff to be well-trained but now wonder if there are other considerations I should discuss or emphasize.
Thank you,
Carole
Parodoxical air emoboli, meaning that the air went to the brain causing severe brain damage. Patients now living in a nursing home unable to care for themselves. The issues are what constitutes an "occlusive" dressing - TSM with gauze and ointment or gauze & tape with ointment. No clear definition on dressing material, but no question that ointment is necessary to seal tract. Also, how long should be patient be required to remain flat after removal. I have found 3 references - 1 hour, 30 minutes, 10 minutes but none are evidence based, other than professional opinions. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
Lynn Hadaway, M.Ed., RN, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861