CAn anyone inform me of what governing body recommends and states the proper PICC tip placement when placed by a nurse? Is this something Board of nursing gets involved with or is it the standards set by INS & AVA? If so which one and where can I obtain a copy of this specifi info. My hospital is getting very specific as to where the tip should be placed and the legal allowance of the nurses placing? I realize the ideal location is the lower third of SVC is the approprate position, but I also want to provide them with data reflecting the importance of giving the patient the best option in different circumstances...possibly a midline if a PICC wont descend due to patient anomolies.
THanks, RN
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
Here's the link for the AVA position paper:
http://www.avainfo.org/website/download.asp?id=1447
Leaving a catheter tip placement out of the suoerior vena cava intentionally is not acceptable
Leaving it out of the superior vena cava after a multidisciplinary conversation with the MD, clincal supervisor, and possible the IR/OR MD's is a risk benefit analysis and patient by patient decision. There are times when the tip is left subclavian, innominate as there is no OTHER access in that patient or the patient is end stage and needs access. Those are clinical desicions
Kathy Kokotis
Bard Access Systems