I am looking for evidence to present to the Hospital I just started working to educate the nurses that it is best practice to removal peripheral IVs once a PICC has been placed. I have searched INS standards and have come up empty handed. Would greatly appreciate any help.
Janet
I would have to ask why the piv is needed if a PICC is in place? Is the piv clinically indicated? I have in fact placed a piv in a patient with a picc. Seems weird but she was going home on long term antibiotics and had a cardiac event landing her from rehab to ICU for amiodarone loading. One or two doses of antibiotics were given peripherally. That was a one-off unusual circumstance, the piv came out quickly. Sometimes the whole picture gets a bit quirky! That's why specialists who understand are needed, and even we won't agree 100% of the time.
We remove all PIVs once a PICC is placed because we want to isolate the source of blood stream infections. PIV placements are not sterile placement and can be a source of a blood stream infection. Another reason is to prevent risk of phlebitis or thrombophelitis from the PIV, which can be another source of blood stream infections. We teach the nurses to check for IV compatibility before placing another PIV access.