We would do the outpatient PICCs in either the ASU or the Outpatient Infusion center ( both places with out-patient beds), occasionally almost anyplace except the busy ER. The patients need to be admitted as an outpatient, and you may have to talk with the admission people to decide just what the best way to do that is. We made them recurring outpatients in the Infusion Department. We would, as much as possible, schedule them a day in advance, but that almost never worked. You need to have some flexability and the ability to set priorities. (This patient is going to come to the outpatient depart. for a daily dose of antibiotics, I can give todays dose PIV and start the PICC tomorrow and schedule time better). Also check with the rules for billing. If a PICC is placed within so many days after discharge you cannot charge for it ( I believe it is 3 days). It is put into the DRGs for the hospital stay. There may be exceptions for this. Our usual out-patient PICCs were for cellulitis, osteomylitis, or or a would infection that did not require inhospital stays.
We have placed outpatient PICCS over the years and gone back and forth with Interventional Radiology as to who should do them. Right now, IR is taking care of these insertions with our PICC team providing back-up as necessary if there increased workload in IR.
The process is that the physician's office, nursing home, home care or wherever contacts the Radiology Dept and a day and time is scheduled based on IR's availability. The vast majority are accommodated that day or the next. They register as an outpatient in the radiology department, have their line placed and are discharged from IR. Setting up home care arrangements (who's giving the med, etc) is the responsibility of the ordering location.
We would do the outpatient PICCs in either the ASU or the Outpatient Infusion center ( both places with out-patient beds), occasionally almost anyplace except the busy ER. The patients need to be admitted as an outpatient, and you may have to talk with the admission people to decide just what the best way to do that is. We made them recurring outpatients in the Infusion Department. We would, as much as possible, schedule them a day in advance, but that almost never worked. You need to have some flexability and the ability to set priorities. (This patient is going to come to the outpatient depart. for a daily dose of antibiotics, I can give todays dose PIV and start the PICC tomorrow and schedule time better). Also check with the rules for billing. If a PICC is placed within so many days after discharge you cannot charge for it ( I believe it is 3 days). It is put into the DRGs for the hospital stay. There may be exceptions for this. Our usual out-patient PICCs were for cellulitis, osteomylitis, or or a would infection that did not require inhospital stays.
Hope this helps.
Gail McCarter, BSN,CRNI
Franklin, NH
We have placed outpatient PICCS over the years and gone back and forth with Interventional Radiology as to who should do them. Right now, IR is taking care of these insertions with our PICC team providing back-up as necessary if there increased workload in IR.
The process is that the physician's office, nursing home, home care or wherever contacts the Radiology Dept and a day and time is scheduled based on IR's availability. The vast majority are accommodated that day or the next. They register as an outpatient in the radiology department, have their line placed and are discharged from IR. Setting up home care arrangements (who's giving the med, etc) is the responsibility of the ordering location.
Wendy Erickson RN
Eau Claire WI