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jenneking
PICC training

We are looking into revising our PICC training policy so that one of our nurses is responsible for training our other nurses,  rather than paying a Rep to come in. I am looking for specific qualifications for such a job, if any exist. Any suggestions??

lynn chase
Many of us need to consider

Many of us need to consider "self study" models followed by preceptorship.  Will the catheter company provide you with a Self Study  Ed pkg for theory and exam (prn) and your nurse provide a preceptorship? 

You could also see if your hospital will purchase a learning program for the PICC Insertion courses for example the PICC Excellance course.

Your preceptorship qualifications could follow the Practice Criteria outlined in INS "Practice Criteria" and "Clinical Competencies" (Vol 29 Jan/Feb 2006) as a framework and make them PICC specific?????  I am in the same process.

Hope this helps.

Pam Jaspers
You may want to check with

You may want to check with the rep for your catheters.  I work for Bard Access and we provide both online training and in person precepting to our customers.  Education is a high priority for us.

 

Good luck

lisayrn
Why would you be paying a
Why would you be paying a rep to come in?  Your PICC supplier (or one who would like to become your supplier!) should be supporting the educational needs of your team.  Our team has had excellent support form our supplier (BARD) and those that would like us to use their PICCs are always offering to educate.

Lisa Y., RN, BSN University of Pittsburgh Medical Center/Horizon IV Therapy

Nadine Nakazawa
It is important that the
It is important that the potential PICC nurse get some kind of didactic PICC and vascular access education prior to beginning PICC insertions.  This can be done by any number of "official" PICC insertion courses (didactic, followed by insertipn on a PICC arm), or an on-line course.   It is important that all the key points be covered in some type of formal way.  

I have talked to nurses who did not receive this prior to starting insertions, and there is so much information that was not passed on to them.  It's very scary.  

Once they've covered the didactic, then the actual insertions could be supervised by one of your experienced nurses, preferably one who is good at teaching, can explain the "evidence" to support each step of the practice, and is very patient and methodical.  

I suggest that the "newbie" observe at least 2-3 insertions, then do just the sterile set up.   Some nurses struggle with just setting up a sterile field and are exhausted by the time they start the actual insertion procedure itself.   Once they've gotten the sterile set up down pat, then have them move in and do the insertion itself.

I strongly recommend keeping in mind how you would teach a teenager to drive.   After telling your kid the basics of driving, would you honestly tell them to drive half way across the U.S. in a new stick shift high performance car, and tell them they can't get lost, they can't get into any accidents, can't get any tickets, and get there in 3 days??   The same thing applies to your newbie PICC clinicians.   Have them attempt only the easiest veins:   large baslic veins, cooperative patients, with no history of venous access problems, no coagulopathies, etc.   

You want to insure, success, success, success.   Once they've gotten the steps down and their confidence up, then you can move to the subtleties of harder insertions.  

The rep may be able to provide a preceptor for a few days, but most established PICC programs don't need that.  For internal consistency with your own hospital's procedure, it may be easier to proctor internally. 

Nadine Nakazawa, RN, BS, OCN, CRNI, VA-BC

lynncrni
All nurses who are beginning

All nurses who are beginning to learn PICC insertions must attend a continuing education course as Nadine described in her previous message. This is crucial to the success of each nurse and can not be omitted. These courses are available from many sources including PICC manufacturers and private education companies. There are traditional classroom courses, self-study paper based courses, and online courses. 

 Following the successful completion of this course, each learner must have a period of supervised clinical practice. It is the decision of your hospital how many insertions must be supervised before the nurse can practice without supervision. Most of the time it is between 3 to 5. The question is who will do this precepting. Manufacturers can provide the continuing education course, however they do not generally have the resources to send a preceptor into each facility for 3 to 5 insertions by each nurse. So your hospital needs to designate a highly experienced PICC nurse that will be responsible for all precepting on PICC insertions. 

 The INS PICC Education Module recommends the following 

Precepting PICC insertions - at least 5 successful catheter insertions

Teaching a PICC course  - at least 25 successful insertions

There are other qualifications listed for those learning to place PICCs including 1600 hours clinical practice over 2 years with IV responsibility, documented experience with CVC management, completing a continuing education PICC insertion course, and completed the period of supervised clinical practice. Lynn 

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

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