I would appreciate it if others in this forum would let me know what your policy is as to the LTC patient which pulls out their PICC. Do you replace it only once, twice? Or do you say that since INS states that this is a contraindication and that if they are confused and pulling out lines, that they aren't a candidate for this line, do you only put short term peripherals in?
Restarints are NOT an option.
We usually give them the two or three "strikes"(pull-outs) and they are out rule, but we are just wondering what others do.
Thank You in advance!
Where does INS state that a PICC is contraindicated in LTC residents who pull out PICCs? Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
From the early 90's, we've always said that this is a contraindication, and I remember the literature published back then which attested to that fact, but honestly, I find it quite curious that it isn't delineated in INS standards. So, perhaps I am Assuming something that isn't there any longer, or wasn't ever there. Don't have my book in front of me, but I'm sure you are quite well versed on them.
Does anyone have a certain number put on the reinsertion attempts, if for no other reason than the complications and cost concerns?
There has to be some evidence to use for a standard of oractice. I have never seen anything related to this question but would be interested in anything others have found. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
If we have a patient who persistently removes his/her PICC whether deliberate or inadvertent, we will replace twice if there is not alternative to therapy. If the child removes the thrid PICC we recommend an alternate device (cuffed tunneled catheter that can be sutured in and better covered with clothing).