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ladena rhoden
PICC Infections

I have reviewed some of the postings on this topic and found them helpful.  I am looking at some of the BSIs that have been noted to be catheter-related at this hospital and see a trend. 

Most of them are in 'train wrecks', but monitoring criteria does not allow for that.  I know that it used to be common to not place a PICC if a patient had positive blood cultures.  We have gradually taken the place of most MD-placed CVCs here, which means we often insert lines in patients that do not show up as having bacteremia until later. 

Do any of you have protocols concerning automatic replacement of a central line in a patient who has positive blood cultures at the time of placement?  In the perfect world, no line would be placed until cultures are clear, but we don't live there.

Robbin George
Julie King PICC team
Julie King PICC team coordinator at Sinai in Baltimore has a very strong and strict policy concerning this topic--I will attempt to make contact and have her respond to this very important query 

Robbin George RN VA-BC

This topic has come up

This topic has come up several times here @ MMC as well, could you please forward to me this same policy.

Do you also have a reference for positive cultures identifying insertion technique as culprit for BSI if taken within ? 5days of placement?


Stephanie Baker

Kristin Walker
Try the Journal of Infusion
Try the Journal of Infusion Nursing, Vol.24,No.3, May/June 2001.  The article is titled "Guidelines for the Management of Intravascular Catheter-Related Infections".  Go to pg 188-189 for a nice algorithm.

Kristin Walker RN, BSN, OCN Maui Memorial Medical Center IV dept.

rivka livni
Since you work in a large
Since you work in a large medical center, why don't you meet with your ID/IC teams to form your our guidelines, that way you can really communicate with the experts, let them know how you feel about it, hear them out, and come up with guidelines that will serve all the different teams in your hospital to do the right thing.
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