I was told by my manager that we don't have policies to place power piccs at the bedside. Power piccs should be done at IR. The other picc line nurse would place only triple lumen at the beside in the icu setting only. I don't understand the rationales. I also think that power piccs; single and double, should be used more in our facility.
Any thoughts? Thanks in advance.
AnnÂ
They don't give me the reason. That is why I am totally confused. I just started working in Jan this year.
Ann
Hi MarryAnn,
Thanks for your input. I use SiteRite 6 to place piccs. But we don't place power picc lines regularly. The other picc line nurse uses only triple lumen power piccs. She does not use single or double at all. Our inventory supplies only triple lumen power piccs.
It seems like a big deal when MD. had ordered a power picc. I am afraid to place the triple lumen because the vein needs to be big to accommodate the 6 Fr. One day,I had spoken with a sales rep and got the info that Bard has single and dual power piccs. That is why I would like to know the reasons for not using power piccs: single or dual as a regular basis when the patients need them.
Ann
There are now hospitals that use only power piccs in all patients. So I do not think this should be the issue. We do not have a crystal ball to determine who will need a CT and who will not. So many will use a power picc on all patients.
The issue is the use of multiple lumens when they are not required based on the prescribed therapies. There is absolutely no reason to place a triple lumen catheter in all patients. This can put the patient at risk for thrombosis (larger outer diameter) and bloodstream infection (more lumens = greater risk of BSI). So if they are not required they should not be present. As always, the choice of size, lumens, and length of all catheters must be based on what the patient needs, not what is easiest to get.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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
Kathy Kokotis
Bard Access Systems
As far as insertion policy and procedure I see no difference in insertion between power and non power injectable PICC lines. Is it a question of supply, money?
To be both catheters insert in the same manner
Kathy
Kathy Kokotis
Bard Access Systems
Kathy,thank you so much for your input. My manager does not do picc lines, so she cannot really give me the reason why.
Ann
Michael Drafz
Vascular Access Specialist
Sharp Memorial Hospital San Diego, CA
Michael Drafz RN, CRNI, VA-BC
Clinical Lead Vascular Access Service
Sharp Metropolitan Medical Campus
San Diego, CA
Michael Drafz
Vascular Access Specialist
Sharp Memorial Hospital San Diego, CA
We have been placing Power Picc's for some years no and do them almost exclusively. We have had too many patients having a Groshong Picc and then we had to place PIV's for CT scans. So even in terms of cost, if you add the additional supplies and time for the PIV start, I would argue that the hospital is loosing money, for sure if the Power Piccs are placed in IR. May be they are confused because they were first released for IR placement in an IR Kit (long wires ect.)
We are also placing many triple lumen Piccs, based on therapy needs. So not everyone in the ICU needs a triple lumen and sometimes the patients on the regular floors have so much iv therapy that they need a triple lumen. So you really have to assess the situation.
So if you are using ultrasound placement in the veins of the upper arms, there is no reason to have a blanket rule to not place certain types.
Michael Drafz RN, CRNI, VA-BC
Clinical Lead Vascular Access Service
Sharp Metropolitan Medical Campus
San Diego, CA