We started our PICC line team in November 2007. There are 3 nurses, one fulltime Endo nurse who does PICC lines when Endo isn't busy, a per deim nurse working currently 4-5 days a week and myself who works 4-5 days a week. When I am not putting in PICC line I work on Ambulatory Care (same day surgery) which is where I worked all the time before I started doing PICC lines.On most days there are 2 of us on together. Part of this was to help each other become comfortable and proficient.Â
Â We also have a PICC line suite, which is an area at the end of one of the nursing units. The area in not near the nursing station so we felt there needed to be two of us because the area is so isolating. We try to do the inpatient in the PICC room to ensure a sterile environment. Patients in ICU and IMC are done at the bedside. Our hospital is a 200 bed facility that includes ER bed. I believe our full in-house census is about 150. OurÂ PICC line insertion numbersÂ still vary greatly from only 7 last week to 14 the week before.Â We also do outpatient PICC lines.Â Â That too varies from day to day on how many we do.
Â Today my nurse manager told myself and the perdiem who was working with me that when we move into a different area, there will only be one PICC line nurse on per day. We will set up in a room at the end of the Endoscopy unit and have one of the free Endo nurse help when we need it. Not sure what will happen when we are in a patientâ€™s roomÂ and how we will get help if needed. We certainly can't ask the floor nurse to stay in for the entire time of insertion and we all know that can vary from 30 minutes to 1 1/2 hours.Â Â
Now I realize many of you do PICC lines alone. I have only done it with someone there. The perdiem nurse and I work very well together and do a team approach as we work together to set up, clean up and document. While one is finishing up the dressing or cleaning up the other can move equipment to the next areaÂ or in many cases transport the patients back, while transport will bring up the next.Â We can do 3 PICC lines in 4 hours. We have a success rate of over 90%.I feel this is in part due to the fact that if one of us is having difficulty the other can step in and help.
We have very few PICC lines we have to send down to IR now. We are the primary PICC line inserters and IR only does the one we can't. Â I guess in my mumbling I wonder how you do it alone. How many times do you break scub? What if you need something because of contamination? Or if you drop something? Do most of you currently work independently??Â
It is my hope that we will increase our numbers of PICC line insertion before they move us so that we can justify have 2 nurses working together.Â Â IÂ appreciate any input or thoughts anyone has. I amÂ new at this and have only been doing this for a few months. I know I am spoiled from having been working in pairs from the beginning.Â
Rhonda Wojtas, RN