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Maintaining PICC competency issues

Is anyone aware if INS or AVA has a set standard on the minimum number of PICC lines that need to be placed each year to maintain competency standards?  Also, does the nurse who needs to be validated for yearly competency need to be observed placing a PICC line?......and if so, who is eligible to do the competency observation?......and how many PICC lines need to be placed under observation each year to show documented competency? least 1?

During the "training" period, does anyone know if a standard has been specifically set for the minimum number of PICC lines a trainee needs to first observe being placed then how many does the trainee need to place under the observation of a preceptor before one is released to work on their own as long as they prove they are safe and competent?

Thanks in advance for any help with this matter! 

There are no specific

There are no specific answers to any of your questions. Neither INS or AVA have established any numbers for initial or ongoing competency. When you read the plethora of information about competency assessment such as the resources from the National Nursing Staff Development Association, there are no recommendations for a specific number of observations for any procedure. Some people could be quite successful within 2 or 3 while others may require 10-15. 

Competency assessment is not required to be on an annual basis, although this is the most common frequency used. Competency should be assessed in the real work world which means direct observation of the complete procedure on a real patient in a clinical setting. Competency means that they individual actually does perform to the desired level as seen in a real setting. Competent as seen in a lab setting with either an anatomical model of a healthy volunterr indicates that the individual has the potential to perform. But the entire procedure can never be completely duplicated in a lab setting.

Who observes is another person designated as one who has this same competency. Finally your competency assessment program should be tied to your actual clinical outcomes. So you do not really need to have an experienced nurse demonstrate a PICC insertion - this is a waste of time and resources. Look at the outcomes and using a performance improvement model and root cause analysis, figure out what aspects of the entire process need to be improved and design your competency assessment program to meet those needs. Yes this means that you will be changing your competency assessment requirements on a periodic basis, but this is the most appropriate method. Lynn

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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