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Gina Ward
Time Out and Site/side verification with picc insertion


We have a checklist that we check off for the steps in the "time out" process .  In the section related to site/side verification I have putting non applicable.  The reason I put this is because  first;  the extremity chosen doesnt make it correct or incorrect regarding procedure verification  as say a right oopherectomy  would.  If i put in a picc line in a left arm or a right arm it is still a picc line and still the correct procedure. ( i know the whole thing about selecting appropriate vessels, sizes, and issues with specifically selecting the best extremity to use to decrease complications or specifici to pt situations )    I also wouldnt think even marking the pre planned vein would be needed or used in site verification;  the vessel may not be able to be cannulated or we may not be able to thread the picc line in or something. 

I am not arguing any point of doing a time out, I am just wondering if we need to be even involving the site/side aspect of it in regards to insertion of a picc line.  I guess it is just like a pacemaker, may start out at left side and then move to right to put it in and it doesnt make it  'wrong site or side used".

How are all of you dealing with this?    Once again, please dont confuse this question with me questioning the importance of site selection in regards to the clinincal aspect of inserting a picc line.  I am only wondering about fully utilizing all aspects of a time out prior to a picc line insertion.

Thanks in advance, Gina Ward R.N., CPAN

Robbin George
The "Time Out" document we

The "Time Out" document we use has many non-applicable statements

References to Blood Transfusions and Antibiotics for example

We just put N/A over the sections that do not apply to PICC insertion

Robbin George RN Vascular Access Resource Dept Alexandria Hospital Virginia

Robbin George RN VA-BC

Gina Ward
  So, does this mean you put


So, does this mean you put NA as I do?  Thanks,  Gina

Gina Ward R.N., VA-BC

mary ann ferrannini
 We just checked this out 

 We just checked this out  and were told the only time we have to mark a site is IF the MD order states Place PICC in the right or left arm...then you would have to mark it and verify it..otherewise we just put exempt

You are correct that you do

You are correct that you do not have to mark a side. You don't even know which arm you will use until you assess the patient (unless specifically ordered by the physciian).


We mark "exempt". 


Darilyn Cole, CRNI

Darilyn Cole, RN, CRNI, VA-BC
PICC Team Mercy General Hospital Sacramento, CA


I do  the same. 

I do  the same.  Non-applicable.

We also write N/A for correct

We also write N/A for correct side.

We may mark the site, but if asked if we mark the site it is for measurement only.

Cherokee people
We write in upper arm. We

We write in upper arm. We don't specify right or left because that is unknown until the patient's veins are assessed.

Karen Day
Karen Day's picture
we don't mark the site either

we don't mark the site either and place N/A on the checklist


Central Line Checklist

We do not use the hospital's "Time-out" checklist for PICC placement or physician placed CVC's. We have a seperate "Central Line" checklist which incorporates all the necessary parts of the "Time-out"  and the component's of Peter Provonost's "Central Line" checklist (and leaves out the items that are irrelevant to vascular access).


Richard Simpson RN, CCRN

[email protected]

Richard Simpson RN, CCRN

Central Line Checklist


Would you mind sharing you Central Line Checklist with me?  We are using the same time-out sheet used in OR, and a lot of it does not apply to us.  We have to state which arm we will be using, and if we're unsuccessful and have to go to the other arm, we have to get another sheet signed.  Thank you!

Bobbi Martin, RN

Archbold Medical Center, Thomasville, GA

[email protected]

We also simply write n/a on

We also simply write n/a on those fields. Our form is a combo-type form that includes procedureal sedation audit and universal protocol. We do this because we are also the sedation nurses. It is easier to have one form and simply cross off things like ASA score and pre-anesthesia assessment when we are only doing a picc.

I think it is better to write n/a because it shows you actually read the form and did what applied to your situation.....not just checking a bunch of boxes.



Robbin George
Richard-- PLEASE share your


PLEASE share your checklist document with the community

by posting it in the documents Link of this web site

Thank You

Robbin George RN Vascular Access Resource Dept Alexandria Hospital Virginia

Robbin George RN VA-BC

Central Line Checklist

I confess I don't know how to post a document here. If you send me your email address I would be glad to share.


Richard Simpson


[email protected]

Richard Simpson RN, CCRN

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