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 Credentialing through the medical staff office is done for licensed independent practitioners, which includes MD, NP, and PA. It does not include other nurses not meeting the requirements to be consider an NP. Knowledge and skill for PICC insertion should be validated by the hospital competency assessmet process. See the INS Standards of Practice on Competency Validation and others on CVAD Site Selection, Catheter Selection, Catheter Insertion, etc. References are included in this book. I am also doing a TargetBSI webinar on competency assessment in June. You can require anything you want such as certification. The key is how do you define "certification". If you use the standard ways that is used by nursing organizations such as ONS, INS, etc. you would be talking about either one of those certiification processes and no others. There are education companies that use this word but do not meet the same processes as nursing organizations. Certification should not be used to indiate that someone has learned how to competently perform a certain task. Certitfication indicates that the nurse has mastered an entire body of knowledge in a given specality practice such as infusion nursing. In my opinion it is entirely appropriate to require the CRNI certification for your nurses who are inserting PICCs. But again, this is will not guarantee that the nurse will be competent in the procedure. This requires initial competency assessment and a rigorous ongoing competency assessment process that is tied to your catheter outcomes. Lynn