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Robin Wanous-Wi...
PICC Fracture

In a skilled nursing facility/long term care setting do you feel it would be appropriate to include a policy/procedure that address steps to take in the event of "accidental" PICC removal or fracture?  Perhaps accidental is not the right word - the resident removes the PICC and may or may not have removed the entire catheter. 

ann zonderman
pulled picc policy

Some type of policy must be available to guide the staff, even if it is to call for help.  Staff should know what to do in an emergency - for preventing air emboli, stop any bleeding, or to clamp the remaining catheter to prevent it from being drawn into the circulatory system.  If they are doing IV therapy, they should have a comprehensive policy/ procedure manual to guide their practice. Of course they should also have appropriate training too.   

 Ann Zonderman, BSN, JD, CRNI, LHRM

Ann Zonderman, BSN, JD, CRNI

lynncrni
I totally agree with Ann. For

I totally agree with Ann. For any organization of any type that is managing patients with PICCs, policy and procedures are necessary for all aspects of what the nurses must do to care for the catheter - dressing, flushing, med administration - and for how to manage all possible adverse events such as catheter dislodgement, lumen obstruction, catheter fracture, vein thrombosis, etc. There should also be documented competency assessment associated with these procedures. Lynn

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

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