Our facility is posing a question as to why all of our adult inserters are not also trained in pediatric insertions. I am very uncomfortable with this idea of cross training because pediatrics is a special population. There are not consistent requests from pediatrics for placements, but when there are, the MD's are expecting them STAT and are unhappy when we cannot place them immediatly. With the inconsistent requests, in my opinion, it would not be safe for our adult inserters to be placing pediatric PICCs. Are there any published articles, studies, or standards regarding Pediatric competencies?