I am interested in the orientation process for vascular access nurses in pediatric facilities primarily, but would be glad to hear from adult facilities as well. My questions include:
How is the length of orientation determined?
Is orientation different for those coming from an adult facility (same position) to a pediatric facility (as opposed to those already in house or with peds experience, i.e. would expectations be different)?
What is the criteria for considering an employee ready to function solo?
Are there a certain number (3 ?) of PICC insertions that dictate competence and therefore completion of orientation?
I know my answers to these questions but have been asked to inquire within the community to see what is the prevailing thought.
If anyone has formal P&P for the orientation process, I would appreciate any that might be shared.
Thanks and Happy New Year
Angela Lee
Hi Angela,
We only do adult piccs but we do a lot of training for sister hospitals. We've found that the training process is very lengthy due to the ultrasound component. We believe that it takes 20 to 30 insertions for someone to really "get it" and be able to practice safely on their own. It varies for the individual however. It's an expensive process training a picc nurse but we won't sign someone off under pressure because they have met a minimum number of sticks. We have to feel that they are competent to work alone. They have to be able to consistently guide their needle tip to the vein while actively avoiding nerves and arteries. If they have 10 placements with an inadvertent arterial stick on the last one they have not achieved compentency.
Our policy is not based on numbers but the trainer's confidence that they are competent.
I hope that helps.
Darilyn Cole, RN, CRNI, VA-BC
PICC Team Mercy General Hospital Sacramento, CA
Our Bedside PICC insertion policy states:
"The prospective PICC nurse will demonstrate competency by observing and assisting in 50 insertion procedures during the orientation period.
The initial competency is completed with ten independent PICC insertions witnessed by a certified VAD nurse.
A separate one-on-one competency will be necessary for those nurses participating in Pediatric PICC insertion.
PICC nurses will complete an annual competency reassessment and peer review."
Robbin George RN Vascular Access Resource Department Alexandria Hospital Virginia
Robbin George RN VA-BC
Thank you for your responses...very helpful.