On our hospital's PICC Placement documentation form, there is a spot to mark how many attempts were made to place the PICC. The other team members and I are unsure what constitutes an "attempt". Is it the number of times we punctured the skin with the needle, even without accessing the vein? Is it the number of times we accessed the vein, even without successful PICC placement? Is it the number of times we tried to complete the placement? We are sometimes unsure what to document, for example if we poked three times, but only accessed the vein on the third try....is that three attempts or one?
Each time you enter the skin with the needle = 1 attempt
This is the same for all catheter insertions. I have seen numerous legal cases of PIV complications where multiple attempts in the same area lead to the complication but the documentation did not help the nurses at all because each site was not known. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
I agree with Lynn. Each time you penetrate the skin is considered an attempt.
We function under the INS guidelines for 2 attempts. If someone exceeds that, I tell them that they are liable and must be able to explain their decision to attempt more than 2.
Gwen Irwin
Austin, Texas