Hello All,
I've read all the previous posts from last year, but wanted more current input to assist me in getting approval for a trial. We are thinking about trying the Navigator marketed by Corpak. Any input from people who are actually using it? Did you use anything before this? Do you like it better or worse and why? Thanks in advance.
Sally Bessonette, RN
We have used Navigator for several years now, and we really appreciate it. It has nearly eliminated post-insertion malposition, and saves us a lot of troubleshooting time. We were able to get it by demonstrating cost savings, comparing the cost of adding the Navigator wire to each insertion procedure, versus the cost of non-reimbursed repeat CXRs taken after attempts to reposition the catheters.
Leigh Ann
Vascular Access Specialty Team
University of Louisville Hospital
Your best resource for who is using this device is from your rep. They should be able to give you a list of hospitals and contacts to get their feedback. They can give you local hospitals or ones all over the nation, if you prefer.
Chris Cavanaugh, CRNI
Chris Cavanaugh, RN, BSN, CRNI, VA-BC
I have used the Navigator in the past. I couldn't imagine putting in a PICC without it. What I used prior to the Navigator was nothing and that was a lovely disaster on a regular basis...delayed therapies due to need for repositioning after xray showed malposition...additional radiation to the patient....additional cost...increased potential for infection when having to reposition after the original sterile field has been broken down, etc. Leigh Ann and I worked on the same team. I agree completely with what she posted. Admittedly, I haven't used any other navigational device. I strongly recommend that you go ahead with the trial. Chris makes a good point. The reps would be able to get you in touch with more nurses using the product, outside of those who regularly post on this site. Good luck.
Monica J. Sorg, R.N.
For Leigh Ann and monica, I have a question about the navigator. We do not use it regularly in our hospital, but I also do some per diem contract work for a picc company who does use this device. My questions is this: there are many times when I can't get the navigator to pick up a signal. I get so frustrated that I just decide not to navigate at all and like you said, it can get very frustrating especially if you have a difficult insertion or even worse the one where you think it went perfect and when you see the film, your jaw drops to the floor because it is coiled, malpositioned etc. I have actually placed the wire into the catheter and navigated the catheter before I put it into the patient just to see if I could get it to pick up and still no beep. However, when I use the navigator in a nursing home that we do insertions for, it works nearly every time. Is there some kind of electrical interference within a hospital that can have an effect on the device? The company I work for has several navigators in use in three different states and has come across the same problem at times. do you have a tip?
I know I can always talk to my rep and though he is great, I really want to get some input from someone who has hands-on experience with the device. Thanks for your help.
Cheryl Kelley RN BSN, VA-BC
I'm sorry, Sally. I haven't been online for a few days. Yes, I have had this problem with the Navigator on occasion. I have encountered 2 problems. The first being, hearing only a one pitched sound when holding the Navigator over the PICC (before insertion), following from the distal to the proximal end of the wire, instead of the rise in pitch, as I should have been hearing. My first suggestion is, as Cheryl mentioned, to be certain that you have a solid connection from the end of the wire that goes into the black receptor box. There is a clear window on the side of the black receptor box where you can see your connection. This will generally correct the one pitch problem. If it doesn't, try changing the battery. In my experience, the only times these 2 tips haven't corrected the problem is when the device needed repaired. Someone may have dropped it, then you try to use it and are frustrated, wondering why it isn't working. It is a very sensitive tool. If you have a 2nd Navigator, switch to it. If that one works, you'll know that the other one likely needs looked at by the company. They will give you a loaner while it is being repaired. The second problem that I've encountered is, once the PICC is in the patient, not getting a signal over the chest. Try following the PICC from the insertion site to the tip, advancing slowly. I say this, because I have spoken with clinicians who have simply held the Navigator over the chest and couldn't find a signal or get an arrow to appear. If it is in the jugular, or my favorite, up the cephalic and back down the basilic, you are not going to see an arrow or get the high pitched sound over the chest. Generally I had no problems if I held the Navigator parallel to the body, not tilting to one side or another. Hope these tips help. Monica
Monica J. Sorg, R.N.
Monica J. Sorg, R.N.
Thanks so much for all the replies. I appreciate the input.
Sally RN