I know this topic has come up before and I have read the posts, but thought I would revisit. My institution currently requires an order for lab draws via PICC (but not TLC). What are the policies for other institutions? We all want to save patient's needless needlesticks, but also want to minimize blood waste (and lab draw anemia) and minimize infection opportunity.
CDC guidelines 2011 make several statements about reducing catheter hub manipulation as much as possible, although they do not address using any CVAD for blood sampling. Infusion Nursing Standards of Practice states this should be a paitent-specific decision after careful risk vs benefit assessment. The greatest risk is increasing your rate of CRBSI through additional hub manipulation. My vote would always be a careful patient assessment with a policy that included practice guidelines about what should be included in this assessment and how that decision should be made. Lynn
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
We do not require a physician's order but we do educate the patient about their PICC and what it can be used for AND the risks of using it for blood draws. Then the patient decides. The risks we cover are increased risk of infection, clotting, and that there may be times when the medications they are on are so essential that they cannot be stopped even for a blood draw, or the possible effects of IV nutrition on the accuracy of lab results.
We have this all on a patient ed sheet. Email me at [email protected] if you want a copy of it.
Wendy Erickson RN
Eau Claire WI