Our facility administration wants to train unit bedside nurses to change PICC dressings and remove PICCs.
Our current PICC program started in 1992 and we have been a full service venous access team performing all PICC insertions, dressing changes, troubleshoots, catheter clearance, and removals as well as the "difficult" PIVs. We are a 1500 bed (approx) facility and insert 500+ PICCs/month. We train the outpatient areas to change dressings and remove PICCs but inpatient PICCs are tracked and monitored by the IV team.
Naturally our team is not pleased about this change and would like to know if there are any other facilities of similar size and volume that have gone through this and what your outcomes were. We already have a very low infection rate (none related to site) and are concerned we will see a rise in infections, replace dislodged PICCs or worse-----PICCs pushed back in because they became dislodged when the dressing or statlock was removed.
Our outpatient nurse training consists of a class followed by validation with the IV Team. We generally requiire 3 precepted dressings/removals to ensure the process is followed demonstrating good sterile technique and documentation is complete.
We are being challenged to provide best practice evidence to support not giving dressing changes to unit nurses. We've been told our training seems excessive and they want to use a train the trainer model. What is everybody else doing?
Can anybody point us to any specific documents/articles to support or not. We have already provided the information from the CDC guidelines re specialty team effectivenenss.
Any assitance is appreciated. Thanks in advance.
Was reading your post, and it caught my attention about the PICCs coming out. You should check into using the SecurAcath device by Interrad Medical. We use it in our hospital facility for PICCs and for CVLs in ICU and it works wonderful. It is very easy to clean around the site, eliminates pistioning of the catheter and prevents the catheter from migrating inward or outward due to it's being so secure. Great product to hold catheters, and decrease BSI rates. Good luck.
PAB