Here's the senario:
PICC inserted Monday tip in cavoatria junction.
Wednesday when rounding a student nurse tells me it is in the jugular but she was told it's okay to use.
Upon investigating I find the Interventional Radiologist told her (and actually dictated) the tip location and that it's okay to use except for TPN and Vanco. What the???????????
Now I have to get into a "discussion" with the Intensivist regarding tip location and appropriatness of use. Of course he wants to side with IR but I won't let it go.
An IR doc who thinks jugular tip location is okay??
Sorry...more of a vent than a post.
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
Lisa Y., Team Leader IV Team UPMC St. Margaret Pittsburgh
Thanks Lynn. I did stick to my guns. My question now is what to do about the Interventional Radiologist? He is not approachable AT ALL. Shall I write up an incident report? Based on the AVA confernce and lectures on tip position I think he should be following some type of standards.
Lisa Y., RN, BSN University of Pittsburgh Medical Center/Horizon IV Therapy
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
Lisa,
Chart well, and by all means, right up an incident report. I would also let the patient be aware of the complications that can arise from this tip position, if the patient is alert and oriented. It is in their body, and they deserve to be allowed to make a decision in thier care. If anything comes of it later, your position will be well stated and supported. Is there a chain of command you could climb with this doc? If he will not listen, take your proof, and go higer. Not at least listening you and being open to discussion of the subject is plain out disrespect in my opinion. I feel your pain. Good luck.
Heather