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PICC Consent/ Authorizations
Our institution is considering removing the need for a consent for PICC insertions. The argument is that it is not a medical act and that the  general hospital informed consent upon admission  is sufficient.  I would like to get feedback, especially here in florida, how many are still using and others that do not. Thanks.fb
Sally Walker
It seems to me that a

It seems to me that a significant rationale for obtaining written consent prior to PICC insersion is that we do what we need to do to help our patients understand what we're doing, why it might be necessary, what some of the complications might be, and what other options exist. We, as nurses, are performing this procedure and our patients are entitled to any and all information we might offer in the way of preparation.

It seems to me that informed consent is our way of ensuring that our patients are part of the decision-making process or at the very least, offering that to those who are receptive. There are many patients who feel that we can do to them whatever we feel needs to be done and I have seen some of those people come to appreciate that they have a say.

ann zonderman
Ann Zonderman, BSN, JD,

Ann Zonderman, BSN, JD, CRNI, LHRM

If you consider the poteintial complications that my result from a PICC placement, would you want to know about them before someone came and told you they were going to put this long IV catheter in you.    While I know the level of expertise  for line placement is advancing rapidly, just what will you say to  defend your self when you get sued because you  had an adverse outcome from the insertion procedure and never shared info with the patient??

It has happened and in Florida...7 million dollar law suit.  You may want to read the article in JAVA from last year about the legal/ medical outcome of a disasterous outcome of a line...  a true case study by myself and Nancy Moureau.   

This is an invasive procedure beyone say the insertion of a PIV>.. it is not the usual nursing procedure we consider covered by the general informed consent one signs when admitted for care. 

Patient's Bill of Rights and informed consent guidelines by organizations such as JCAHO are sources to consult in guidance.  While you may do away with a form to confirm that the patient received all the appropriate info to make an informed choice, you porbably should not do away with the education process and documentation that the patient was provided the info, opportunity to evaluate  and be involved in deciding the best course of treatment for him or herself.  Some facilities have a book or video for educating the patient, this is great... just put it in place and document the process - Develop a policy that reflects all of your steps.  then you can likely  eliminate the " informed consent FORM."

Personally, no one is doing anything to me without telling me what and why and + / -

Ann Zonderman




Ann Zonderman, BSN, JD, CRNI

mary ann ferrannini
 I too was a little freaked
 I too was a little freaked when I heard our hospital put it on the list of procedures that will no longer require a written consent. I have been placing PICCs since 1989 and have been on a hospital IV team since 1986 and I know that this is not a simple procedure and is not without immediate complications as well as potential long term complications. I wanted to make certain our team was all on the same page. The patient or their surrogate or conservator must still agree to the procedure and have all the information available to make an informed decision. In addition.I made sure that we all with 100 % compliance documented this with each PICC insertion. Once that was in place I was comfortable with the change.  We also continue to document patient and family teaching and document the understanding of that teaching as well as providing written information and documentation that they have received it. I work in California.
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