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PICC line placement

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

The Infusion Nursing
The Infusion Nursing Standards of Practice is the document to which all nurses are held accountable and it does state the preferred tip location. You can purchase this document online at AVA has a journal with several articles about tip position and a position paper on PICC tip location. This paper is several years old but I think they would still provide a copy to you if you called the office - 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

Here's the link for the AVA

Here's the link for the AVA position paper:

THank you for your
THank you for your responses...very helpful! I will obtain.
Leaving a catheter tip

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

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