Forum topic

1.  24/7/365
2.  PICC nurses carry a pager - floors page them with consults.
3.  The PICC nurse - usually responds ASAP, or negotiates a time if the pt. is going to surgery or other procedure - we work around it.
4.  We don't really "allow" time for insertions - we take however much time we need to insert it.  Average time is probaby 1 1/2 to 2 hours.
5.  We have 7 who actively insert PICCs.  Usually one PICC nurse is placing PICCs each 12 hour shift, but second PICC nurse on days can also assist and place.
6.  We currently average 75 a month.  (hospital has an average daily census of around 112)
7.  Go to the room
 

We do not use any kind of scheduling system - we respond as we get the requests.  Outpatients needing a PICC are seen in Interventional Radiology and that IS scheduled by the Radiology dept.

1.  Piccs are placed Monday through Friday;  I started coming in at 7;30 only to find the work doesnt really get going to later due to doctors rounds etc  so now  9:00 untill all done mostly 4:30 sometimes 7 pm. 

2. I recieve requests by a computer generated order that was entered in the system after a written order from the physician on the chart.  the order is entered in by the unit secretary and the requests prints up in the OP department.  the OP nurses or secretary then call me to let me know the consult as been ordered.  I usually walk through OP every 1-2 hours and check my box for any consults.  They place the orderd consult in my box in the event I was unable to answer the phone , so we have a back up plan for me knowing of a consult.

3, Arranging of time;  when I recieve the consults if there ar more than one I prioritize them according to indications  and do them accordingly.  If there is an OP picc needed say from teh nursing home, or patient in OP then I scheduled it according to bed availiablilty in the OP deparment as well as my other consults.  All the PICCS are done the same day they are ordered, unless some contraindication or pt availabitly issue.  If ordered on the weekend when I come in on Monday I take care of it. 

4.  It usually only takes about 45  minutes for the actual placement of the Picc line but;  when you recieve the consult review chart, indications, contraindications, hx and then talk to pt, educate obtain consents and pre assess the vessels, then when done waiting on cxr I would say almost 2 hours for each line inserted. 

5.  I am the only RN who places PICC lines in our facility.  We orginally had two and one day I would PICC and the other day the Other would picc and we would work in our departments and try to juggle the job.  that worked horribly so now I just do it FT.

6.  I usually average any where from 30-60 piccs a month.  As little as none one day and as many as 7 another day.  I also do all the care and maintaince of the lines, cap changes, dressings, trouble shooting and removals. 

7.  I go to the patients room for the procedure. 

8 .  I am pleased with my current system.  would love more access to data collection of others . 

Hope this helps,  Gina Ward, R.N, Raulerson Hospital 

1. What are your current hours for placing PICCs (24/7, 0800-1700, etc.)?

7-5 Monday - Friday, 7-3 on Weekends and Holidays (try to place last PICC 1 1/2 to 2 hours before end of shift)

2. How do you receive PICC placement requests (computer generated order, phone call, etc.)?

We are paged for PICCs, we also receive a computer generated order but require staff to page (not always in office to see printed order)

3. Who arranges the time for PICC placement?

Collaboration between PICC nurses and patients schedule (usually place based on prority of need), we do have some outpatients scheduled via outpatient clinic (we try to schedule then in morning)

4. How much time do you allow per PICC placement?

usually takes 1 1/2 - 2 hours. we allow as much time as needed

5. How many PICC RNs do you have in your institution? How many RNs place PICCs at any given time?

3 full time PICC RNs & 1PRN PICC RN.  Usually have 2 working Monday - Friday and 1 on weekends and holidays. We try to have 2 PICC RNs during placement (1.both can be sterile for preping kit, 2.one can monitor sterility, 3.assistant that knows what you need quickly, 4.2nd person who can attempt if needed). Weekends, holidays, and when we have too many orders we will place PICCs with only 1 RN but this does not seem as efficient or safe to us (still working on how to prove this financially to add more staff) 

6. How many PICCs does your team place monthly/yearly?

50 to 70 monthly, 700 to 750 yearly

7. Do you have a central location or do you travel to the patient's room for the PICC placement?

Travel to patients room (would prefer central location for most patients and only travel for the critical)

8. Are there any problems or room for improvement with your current system? If so, what?

Always room for improvement. We should never settle for the way things are but should always search for the better, safer way to care for our patients. Would be much less stressful for us if we had a designated room and scheduled patients to come to us ever 2 hours. Seems that sterility would be better and we could possible place more PICCs since we would have the time it takes to travel all over the hospital.

Thank you so much for your time!

1. We place PICCS 7 days a week/ usually btw hours 7am-5 or 6 pm, depending on staffing.

2. Computer orders, sometimes get paged by nurse or MD for critical/ urgent PICCS.

3. PICC nurses arrange time....prioritze and re-prioritize as the shift goes on.

4. No set time ....usually anywhere from 40mins -60mins...but could go longer.

5. There are 9 PICC nurses, both full and part time. We always place PICCS with 2 nurses...unsafe to do otherwise.

6. Around 1200/year

7. Pt's room...would like to have a location...would def save time.

8. Centralized location, more respect from upper nursing management.

We have an IV team/OR team that place piccs

1. Current hours are 7a-7p x 7 days/week

2. The IV team has a pager, The OR team is called by IV team for PICCS that day.  Patients are scheduled for PICC placement when their surgery is booked.  The IV team has a sedation room, The OR team has separate room for add-ons.  If you are a hospitalist with booking priviledges then you may add on a line in the OR.  Most PICCs are usually finished the day they are booked.

3. Outside the OR the IV team arranges for the time, but they also have sedation from 9-12 everyday.  In the OR the case is either an add-on, already booked or booked ahead of time with the procedure.

4. For the IV team they average about 1.5-2 hours. In the OR we are usually finished in 30 minutes.

5. At least 15. In the OR I like to have two if it is a baby. The IV team makes due with one RN, however on infants they will call us to come and help.  I do believe, though, they should be done with two RN's to maintain proper sterility.

6. 1500/year

7. OR>Sedation area and bedside

8. I think there is always room for improvement, that being said>> in the OR we also do the IV starts on 12 and over pre-surgery.  I would like to see two of us on at any given time, however not always feasible for staffing.  I do believe the IV team would enjoy more staffing especially on the weekends.

Pam Garavano RN

Boston