PICC Teams that are placing IJs/Dialysis catheters/Art lines/PICCs,etc
I am trying to gather data from teams that are currently placing IJs, femorals, art lines, PICCs, etc. Any input provided would be much appreciated. Thanks!
Our team of two are placing IJs, axillary/subclavian, femoral and artlines. What kind of data or input are you looking for? Outcomes, how to get started? Have you attended a workshop yet?
I am looking at a practice model of what others are doing. One of our trauma physicians is interested in growing our PICC team in a progressive direction. Our team is very excited and are reaching out to others.
Are you in a hospital? Size? Location?
Number of lines placed per month?
Complication rate for your IJs?
Team coverage? (24/7?)
Consult/Referral process: does your team evaluate the patient and determine the type of IV device, and then make your recommendations to the physician?
Type of catheter(s) used
For the IJ and femorals placements - do you perform these insertions solo?
Do you utilize any tip location devices (Sherlock, 3GG, etc.)?
Do you place interosseous lines?
Are your lines placed at bedside?
Do you have criteria for renal patients requiring lines?
As you can see I have alot of questions. Thanks for your feedback!
I am looking at a practice model of what others are doing. One of our trauma physicians is interested in growing our PICC team in a progressive direction. Our team is very excited and are reaching out to others.
Are you in a hospital? Yes Size? 480 bedsLocation? 1 hour west of Chicago. We are the first time in the state to move to CVC placements
Number of lines placed per month? 80-100 1.4 FTEs :(
Complication rate for your IJs? We place IJ, Axillary/Subclavian and femoral lines including arterial lines. We have had zero complications since we started in August.
Team coverage? (24/7?) M-F 8-4 give or take if we are busy we stay. Sat 9-1pm. As our value grows we hope to expand our coverage.
Consult/Referral process: does your team evaluate the patient and determine the type of IV device, and then make your recommendations to the physician? Yes, they consult us. We decide what type of line to place. If we recomend a port or tunnelled line the physicians orders it.
Type of catheter(s) used we use teleflex CVCs called the JACC. The JACCs are MST. We have leard to do them both ways MST and ST. We were also tought to suture. Some patients may need to have them sutured in, one way does not fit all patients.
For the IJ and femorals placements - do you perform these insertions solo? NO, the nurses are expected to be in the room like they are for physicians. PICCs we are solo.
Do you utilize any tip location devices (Sherlock, 3GG, etc.)? We went with the VPS because it can be used for PICC and CVCs by nurses and physicians. We hope to eliminate CXRs for CVC placement by end of summer.
Do you place interosseous lines? We can, we will be having the cadaver lab at our hospital to get ER, ICU and other key clinaicans more comfortable with placing them.
Are your lines placed at bedside? Yes, all line are placed at bedside even the ED.
Do you have criteria for renal patients requiring lines? We follow the standards, if an ESRD patient gets a PICC order we will place at right IJ.
As you can see I have alot of questions. I am happy to help, will you be at INS next week? There will be a breakfast on Monday morning on this very subject. Its very impowering to be with a group of clinicains that have the same vision as you. I hope to see you there. Thanks for your feedback!
Number of lines placed per month? 230+ (110 PIV/120 PICC avg)
Complication rate for your IJs? We're not doing IJ's YET...lobbying efforts with Boards of Regents/Nursing/Education. Scope of practice review is ongoing.
Team coverage? 07:00-5:00 M-F, 08:00-13:00 on Sat 4.0 FTEs
Consult/Referral process: does your team evaluate the patient and determine the type of IV device, and then make your recommendations to the physician?
We always advocate for the most appropriate access devices. We have a very good relationship with the hospitalist service as well as our IR department. Based on our assessment & recommendations the MD will usually order what we suggest. Also, the RN staff can order a Vasc Access Team consult, to help "facilitate" a vascular access dialog with reluctant (usually, Resident) physicians.... :)
We don't have an early assessment program though. But it's in the works....
Type of catheter(s) used: BD 1.88" 18/20 ga PIVs for U/S guided access, Angiodynamics PICCs, Bard Powerglide Midlines. I HAVE NO VESTED INTEREST in any of these companies or products.
For the IJ and femorals placements - do you perform these insertions solo?: We will occaisionally be asked to assist in CVC placement but cannot perform these independently. These cases are usually emergencies and everybody and their brother is in the room anyways.... :) (....AND we're usually back in 24-48 hrs to place a STERILE PICC line....)
Do you utilize any tip location devices (Sherlock, 3GG, etc.)? No. Evaluated some, liked some, but our radiology staff are ON their game. CXRs are done within 20 minutes (usually less) and "OK to use" is within the hour. All things considered, the ROI was not there.
Do you place interosseous lines? We can, unusual for us though. The Rapid Response Team are highest users.
Are your lines placed at bedside? Yes
Do you have criteria for renal patients requiring lines? We follow the Kidney Disease Guidelines, but evaluate every request and have placed PICCs in dialysis patients who's clinical picture warrants that device.
As you can see I have alot of questions. Thanks for your feedback! Questions are GOOD !
Our team of two are placing IJs, axillary/subclavian, femoral and artlines. What kind of data or input are you looking for? Outcomes, how to get started? Have you attended a workshop yet?
I am looking at a practice model of what others are doing. One of our trauma physicians is interested in growing our PICC team in a progressive direction. Our team is very excited and are reaching out to others.
Are you in a hospital? Size? Location?
Number of lines placed per month?
Complication rate for your IJs?
Team coverage? (24/7?)
Consult/Referral process: does your team evaluate the patient and determine the type of IV device, and then make your recommendations to the physician?
Type of catheter(s) used
For the IJ and femorals placements - do you perform these insertions solo?
Do you utilize any tip location devices (Sherlock, 3GG, etc.)?
Do you place interosseous lines?
Are your lines placed at bedside?
Do you have criteria for renal patients requiring lines?
As you can see I have alot of questions. Thanks for your feedback!
Cindy Hunchusky, BSN, RN, CRNI
I am looking at a practice model of what others are doing. One of our trauma physicians is interested in growing our PICC team in a progressive direction. Our team is very excited and are reaching out to others.
Are you in a hospital? Yes Size? 480 bedsLocation? 1 hour west of Chicago. We are the first time in the state to move to CVC placements
Number of lines placed per month? 80-100 1.4 FTEs :(
Complication rate for your IJs? We place IJ, Axillary/Subclavian and femoral lines including arterial lines. We have had zero complications since we started in August.
Team coverage? (24/7?) M-F 8-4 give or take if we are busy we stay. Sat 9-1pm. As our value grows we hope to expand our coverage.
Consult/Referral process: does your team evaluate the patient and determine the type of IV device, and then make your recommendations to the physician? Yes, they consult us. We decide what type of line to place. If we recomend a port or tunnelled line the physicians orders it.
Type of catheter(s) used we use teleflex CVCs called the JACC. The JACCs are MST. We have leard to do them both ways MST and ST. We were also tought to suture. Some patients may need to have them sutured in, one way does not fit all patients.
For the IJ and femorals placements - do you perform these insertions solo? NO, the nurses are expected to be in the room like they are for physicians. PICCs we are solo.
Do you utilize any tip location devices (Sherlock, 3GG, etc.)? We went with the VPS because it can be used for PICC and CVCs by nurses and physicians. We hope to eliminate CXRs for CVC placement by end of summer.
Do you place interosseous lines? We can, we will be having the cadaver lab at our hospital to get ER, ICU and other key clinaicans more comfortable with placing them.
Are your lines placed at bedside? Yes, all line are placed at bedside even the ED.
Do you have criteria for renal patients requiring lines? We follow the standards, if an ESRD patient gets a PICC order we will place at right IJ.
As you can see I have alot of questions. I am happy to help, will you be at INS next week? There will be a breakfast on Monday morning on this very subject. Its very impowering to be with a group of clinicains that have the same vision as you. I hope to see you there. Thanks for your feedback!
Constance,
Yes I will be attending the INS Conference. Where is the breakfast meeting located on Monday morning? Thanks! [email protected]
Cindy Hunchusky, BSN, RN, CRNI
Are you in a hospital? Yes
Size? 650+
Location? Albany, NY
Number of lines placed per month? 230+ (110 PIV/120 PICC avg)
Complication rate for your IJs? We're not doing IJ's YET...lobbying efforts with Boards of Regents/Nursing/Education. Scope of practice review is ongoing.
Team coverage? 07:00-5:00 M-F, 08:00-13:00 on Sat 4.0 FTEs
Consult/Referral process: does your team evaluate the patient and determine the type of IV device, and then make your recommendations to the physician?
We always advocate for the most appropriate access devices. We have a very good relationship with the hospitalist service as well as our IR department. Based on our assessment & recommendations the MD will usually order what we suggest. Also, the RN staff can order a Vasc Access Team consult, to help "facilitate" a vascular access dialog with reluctant (usually, Resident) physicians.... :)
We don't have an early assessment program though. But it's in the works....
Type of catheter(s) used: BD 1.88" 18/20 ga PIVs for U/S guided access, Angiodynamics PICCs, Bard Powerglide Midlines. I HAVE NO VESTED INTEREST in any of these companies or products.
For the IJ and femorals placements - do you perform these insertions solo?: We will occaisionally be asked to assist in CVC placement but cannot perform these independently. These cases are usually emergencies and everybody and their brother is in the room anyways.... :) (....AND we're usually back in 24-48 hrs to place a STERILE PICC line....)
Do you utilize any tip location devices (Sherlock, 3GG, etc.)? No. Evaluated some, liked some, but our radiology staff are ON their game. CXRs are done within 20 minutes (usually less) and "OK to use" is within the hour. All things considered, the ROI was not there.
Do you place interosseous lines? We can, unusual for us though. The Rapid Response Team are highest users.
Are your lines placed at bedside? Yes
Do you have criteria for renal patients requiring lines? We follow the Kidney Disease Guidelines, but evaluate every request and have placed PICCs in dialysis patients who's clinical picture warrants that device.
As you can see I have alot of questions. Thanks for your feedback! Questions are GOOD !
David Bruce RN