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debbie kenkins
PICC flushes in home care
 As an ICU nurse with no outpatient experience, I find very confusing information on outpatient PICC care. How often do PICCs need to be flushed in the out patient setting?  Should a heparin solution be used? Does the use of hep-flush reduce the frequency of the flushing as outpatient?  The literature we have to give the patients does not seem to address this.  I feel this is important teaching info- but  can't find any clear answers.  Can you help?
There are no clear answers
There are no clear answers on the required frequency of catheter flushing for any healthcare setting. For inpatients, catheters are commonly flushed every 8 to 12 hours or after each intermittent infusion. For home care patients, the patients are taught to flush after intermittent infusion. For outpatients, they are flushed after each infusion in the infusion suite. Heparin is the standard solution for locking at catheter at the present time **unless** you are using a valved technology (either integral or add-on) with instructions stating saline only flushing is acceptable. The other exception is when the patient has been diagnoses with HIT. There is much controversy about heparin right now but there is no other anticoagulant on the market with an approved indication for catheter locking. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

ann zonderman
Ann Zonderman, BSN, JD,

Ann Zonderman, BSN, JD, CRNI, LHRM

The patient should be sent home with a flushing protocol prescription - this may be based on the hospital protocol, the physician preference, the agency monitoring/ providing supplies/ medications and may also follow manufacturers fluhsing recommendations.

 What works in the hospital doesn't always work at home. More frequent use in the acute setting = more frequent flushing.  Patients instructed that the line may be flushed less often than daily, may experience occlusions and need to declot the line, 

 The discharge planner should be coordinating care for followup / monitoring and may be a resource to determine what protocol will/ should be followed.

As you PICC staff to provide you some info re manufacturer recommendations, it may be in the product literature for the lines they are placing. 

Ann Zonderman, BSN, JD, CRNI

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