Our hospital has exclusively placed nonvalved picc's. It has been proposed to also have a valved picc option. Nursing Education is concerned that having two types of picc's, which require different care practice, may be an end user issue.
Could anyone provide feedback regarding their institutional practice and/or literature sources on the pro's/cons of each?
The only real difference was the use of saline vs heparin for locking. Now the evidence is strong for saline only locking for all VADs. So what advantage does a valve bring? If you are already using saline for all VADs, then there should not be any difference in their care. If you are thinking about this to eliminate heparin, there is no need for a valve since evidence does not require a valve for saline only. So what purpose or benefit do you expect from a valved catheter? When the valve is inside the bloodstream, there is no guarantee for protection against air emboli or backflow of blood if the valve is help open by fibrin - a documented problem. There are 2 options for valves in the hub and they are no subjected to the same proteins in the bloodstream, so there might be some benefit to prevent air embolism with those. I think it all comes down to what do you expect a valved PICC to do or bring or add to what you are now doing?
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