My facility is trying to institute a catheter exchange practice and policy. The following are the comments and concerns from some of the team members who are writting the policy:
1. Alice Cenanno originally wrote a catheter exchange policy as an over the wire policy in 2003. She revised it in 2007 and removed the over the wire techniques. It was stated that she changed the policy related to the manufacturers unwillingness to provide written support for this procedure.
2. The 2006 INS standards referenced catheter exchanges by an "over the wire technique," but did not state the RNs should perform this procedure. The 2011 INS standards no longer references an over the wire exchange.
3. The INS standard 55 that the exchange with be performed under organizational policies and procedures, and/ or practice guidelines and according to manufacturers directions for use.
4. It was stated that using a guidewire is a "dangerous act" r/t drug precipitation or other occlusion
5. It was also stated that not everyone who places a PICC should be allowed to exchange a catheter.
We would like to do catheter exchanges, there seems to be conflict about what nurses at the bed side should exactly be doing.
And if anyone knows Alice Cenanno, I would love to talk to her.
Matt Gibson RN, CRNI, VA-BC