Our hospital policy had changed as far as practices in regards to flushing PICC lines, Broviac catheters and IVAD's in regards to using or not using heparin. We currently use the neutral needless access device on all lines (microcalve). What are other institutions doing in the pediatric population?
Thanks
Cheri Gillette RN VA-BC
University of Rochester Medical Center
Golisano Children's Hospital
Heparin lock for CVLs for the following reasons: 1. There is not enough evidence in peds to eliminate heparin, 2. There is a bit of reflux with Microclaves even though they are neutral, 3. INS standards still support Heparin for both adult and pediatric CVL locking due to the risk of clotting and losing the line.
We use a saline lock for PIVs in pediatrics.
Virginia Pohlod, ARNP, CRNI, MS- All Children's Hospital, St. Petersburg, Florida
Our hospital has totally eliminated instilling Heparin into CVAD's except when deaccessing a portacath. We have encountered many problems with lines clotting, not flushing, and not aspirating. The policy was to use 100 units/ml Heparin for all CVADs. Now we use none! Our cathflo use is very high.
I think maybe changing to Heparin 10 units/ml at least may help with this problem. This hospital doesn't use any heparin on an accessed port that is being used intermittently. This all pertains to adults but I would be interested in hearing what other facilities are doing.
psb55
This is the type of process and outcome data that needs to be tracked and reported, then converted to dollars for a cost analysis. Anybody already taking those steps? 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
Cheri:
Currently this is a topic that goes round and round at our facility. About 6 years ago we attempted heparin free, only to have increase in clotted PICC lines. We are now heparin flush for all central lines.
Everytime the topic comes up,I mention that the cost of cathflo, IV team time to declot the line, missed medications due to lack of access all cost money.
I am in the process of tracking the dollars for the accounting department.
I am not convinced that heparin free is best.
Lois Rajcan
The Chester County Hospital
Most PICC manufacturers state their catheter require heparin. Studies are also coming out saving DVT’s connected with PICC is less when the line is maintained with heparin. I didn’t hear whether the reason this was the case had been found, but at our institution we have held firm on heparin citing the manufacturer’s guidelines.