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Amy Graham
SHEA Practice Recommendation- PICC placement should be observed

I was reading a forum topic on the time out procedure.  One of the posts discussed the SHEA practice recommendations to prevent CLABSI in Acute Care Hospitals.  The recommendation states - CVC insertion is oberved by a nurse, physcian or other healthcare personnel who has received appropriate education, to ensure that aseptic technique is maintained.  I place PICC lines alone and am the only PICC trained RN in my setting.  I follow INS guidelines in my practice.  Does anyone know how important it is to follow every practice recommendation created?  Any thoughts on this topic?  

I also read that and am in

I also read that and am in the same position as you are.  We are due for our joint commission survey any day now and I am afraid we are going to find out the hard way how serious they are about this recommendation.

BJ Sherman, RN

Memorial Hospital, Jasper Indiana

 Joint Commission has a new

 Joint Commission has a new set of guidelines on CLABSI out last year. Have you checked that document to see what they are saying about this? It is a free download from their website. Lynn

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Random VAT person
We just received our visit

We just received our visit from Joint Commission.  They noted we used a PICC team and that we documented # of needle access attempts.    Just an FYI.

Gina Ward
one man PICC team: time out and observer



I remember when I first started doing PICC lines the  issue arose  of doing a Tiime out with only myself and the patient.  .  I sent a specific question to JCAHO  abouth this and they replied that I did NOT need to have another person present.  As long as I personally did the Time Out  that it was acceptable.  I even have the question and answer printed up but cant find it at this time.

I too am a one person PICC team, the only person :)  .   I know with recommendations verbage is a guide; where with this recommendation it says;    CVC insertion should  be observed by a nurse, physician, or other healthcare personnel...........


It says should, not SHALL .  I am hoping this gives us some leverage if an issue does arise.  When I first started doing PICC lines, it was me and another nurse , brand new, doing them( because we needed eachother for moral and troubleshooting support)  When we got comfortable it seemed a waste to have 2 people in the room.  We tended to send one of us out to see other patients and do other things not so much stay in the room when doing a procedure. 


I had a surveryor come to me a year or two ago, ask me some questions , have me show her our documenting, she asked about time out and site marking etc.  ( told her I do not site mark for a PICC line and explained why).   All went well,  she was well aware that I was the only one doing these procedures and no issue arose.  During her visit I did not have her in to observe an insertion though. 



Gina Ward R.N., VA-BC

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