I observe a PICC inserter who already puts on double gloves and wear sterile gown.
In the middle of the procedure, she puts a sterile bag (that comes in a PICC kit ) as the third layer of gloves to untie a tourniquet where she has to go under the max barrier to touch the pt's arm (under sterile field). Once, she unties a tourniquet, then she removes this bag. She touches only the top part that isn't touch the pt and throws the bag away. Then, she proceeds with the procedure.
Is it an unacceptable technique?
What do you think? Thanks for all the inputs.
NO, once placed the drapes should not be disturbed until the field is totally removed. A tourniquet is not needed for use with ultrasound. If you still want to use a tourniquet, leave the tail of it so it can be found and released from the top of the drape, or have the assistant reach under the drape to remove it. But most inserters are not using tourniquets now. Tourniquets will distend superfical veins but you are accessing deep veins, so effect of tourniquet is questionable. Also if it does cause some distention, you cannot rely on that measurement for CVR because the distended vein will not be the same CVR as the nondistended vein.
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
Thank you so much Lynn. You always give me a very clear cut answer. I love you :)
I also have a question when this person is wearing a sterile gown. Her steps as follows;
Step 1: Put on the first pair of sterile gloves.
Step 2: Put on sterile gown
Step3: Put on the second pair of sterile gloves.
Then proceed with the procedure. After put a dilator, there'll be some blood touching the gloves.
After that, she'll take off these bloody pair of gloves and throw them on the max barrier (that's covering the patient's body). Then put on the third pair next to the dirty pair.
Now, she'll proceed to insert a line.
My question is , are these steps are ok to do?
Thanks so much again Lynn.
Not quite. The full proceedure details are outlined in the INS Polices and Procedures for Infusion Therapy.
Gown first. Then both pair of sterile gloves, preferably using the closed glove method (google it). OUter pair of gloves is removed after skin prep then proceed with other steps. Removed gloves should be dropped off the sterile field and dirty and sterile should be kept separate.
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
Thanks so much! I'll share it with my co-workers.