Does anyone use a nurse driven PICC/central line removal protocol? Ie. an order set that allows the vascular access nurse to insert the line, review that need for it daily and remove and replace with peripheral access when it is no longer indicated?
Does anyone use a nurse driven PICC/central line removal protocol? Ie. an order set that allows the vascular access nurse to insert the line, review that need for it daily and remove and replace with peripheral access when it is no longer indicated?
I would love something like that as well. We have nurse driven protocol for foley cath removal, why not piccs for vascular access RNs? The only problem I can forsee with it is that some doctors insist on keeping them despite best practice and/or there might be potential future IV therapy we might not be unaware of.
Rob Renander RN, CCRN, VA-BC
I agree, Rob. The problem you stated about physicians is all the more reason to advocate for a nurse-driven removal protocol.
Sheila Hale, MSN, RN, CRNI, VA-BC, Austin, TX
why are you removing a central line to replace with a peripheral? is access still needed?
and yes, sometimes Licensed Independent Practitioners do have a plan of care that has not been yet communicated. This is why collaborative care is needed.
Fewer central line days equals less chance for a clabsi. Our rates our up and we try to get them our asap.
Rob Renander RN, CCRN, VA-BC
Hi Jill,
Agree with you as well, however, it is appropriate to remove a CVAD if it is not needed, but yes, this is why is collaborative effort is always best practice. :-)
Sheila Hale, MSN, RN, CRNI, VA-BC, Austin, TX
I have serious concerns about switching from a CVAD over to a PIV while there is still infusion therapy prescribed. Even if the therapy does not require a CVAD, there are more issues to consider. I know length of dwell can increase risk of BSI but that risk is coming from intraluminal not extraluminal. Does a difference of 3 days vs 10 days make a huge difference in CLABSI rates? To me, this says that "our nurses are not capable/willing to do what is needed to prevent CLABSI so we are going to make the patient be stuck many more times." 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
Just want to say BRAVO to you Lynn.