We have a full service IV team - 24/7 vascular access services, PICC service 7 days/week 7-5:30. We have about 28 staff, 11 of us place PICCs as well as the rest of the access services. The other staff provide only non-CVC access services.
The group is discussing pros/cons of a proposal to limit the number of people trained to place PICCs/Central Lines (JACC) and create a dedicated PICC/CVC team - placing central lines is all they would do. The rest of the staff would perform the rest of the non-CVC placement work. We'd love to hear your thoughts pro and con.
I don't think these teams should be separate teams. They should all be under the same organizational structure with the same management. Patient care and VAD management is directly connected to choices made before and during insertion. However, the roles of these teams members could and probably should be separated. This is the way we started with PICCs in 1980-81. The IV Infusion Team had specific nurses designated as a PICC inserter and staffing coverage required that a team member with this skill was assigned to all shifts. Night shift did not have much call for PICC insertion in a 250 bed community hospital but there could be a need for someone with these advanced skills for insertion occassionally. This would depend upon your patient population and their needs and how proactive your staff is about VAD planning for all patients during the regular business hours. I definitely agree that some infusion nurses may not want or be able to expand their scope of practice to insert CVADs but that does not indicate that they have no place on a team. There are many patient care activities they can be assigned to do. I also agree that those who do place CVADs should be the ones with the advanced knowledge, critical thinking, and psychomotor skills and the willingness to accept the accountability for their actions. Not every infuson nurse wants to or should be expected to fill this role. Please let us know the outcome of your decisions and how the proposal is accepted. 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
We are a PICC team of 3. We cover entire week and work 12 hr shifts. So most times there is only one of us on at a time. Would like to know beside placing PICCs what other service does your team provide. We do help with difficult PIVs and review pt charts for potential PICCs. I would like to see us being more of a resouce to staff.
Debra Rivie RN VA-BC
Long Beach Memorial Medical Center
Long Beach, CA
The list of services that could be done by a team is endless! VAD planning, accessing implanted ports, assessing all sites on a regular basis for complcations, serving as a resource for any issues or complications, changing all dressings on all CVADs, expanding to insert IJ and subclavian CVADs, catheter clearance for all types of occlusions, tracking outcome data for all PIVs and CVADS, education to all staff, involvement with all product evaluations, etc, etc, etc. These activities, interventions, tasks, are what I have done on other teams where I have worked and known that many other teams continue to do all of this and many other activities with drug infusion, PN, and blood transsfusion. 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