I have heard over the past couple of years the call for two person vascular access teams at conferences and it is even mentioned in my hospital's official procedural guide, Lippincott's. Now the two person teams approach is not mentioned in the 2011 INS Standards of Practice, the 2011 INS Policies and Procedure, nor in the 2011 CDC Guidelines so where is it coming from? We are evaluating our current vascular access policies and would love to adopt the two person teams but are there any standards or recommendations in writing that I can refer to?
Thanks,
Asystole BSN, RN, CRNI, VA-BC
Remember all the documents your mentioned were published in 2011. That means that the studies used to write those documents were from before 2010. Yes it takes that long to get these documents produced. Anything that may be discussed now or was published 2010 or later was not considered for these documents. I am not sure if there is anything now that highlights a difference in outcomes with a 2 person approach. It would require some type of evidence to address this issue. CDC would only address it if there is significant evidence about infection reduction. 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 have been using this model since we began placing picc many years ago. This is our rational.
A time and motion study demonstrated that we were more efficient. An experienced inserter as your assistant means faster insertions.
Joint commission states that you must have an empowered observer present for all central line insertions, who better identify if sterile technique is broken than another picc nurse.
This model would work nearly as well with a non-rn who is specifically trained to assist.
Using this model we have better success rates and outcomes.
I'll be happy to answer any specific questions you might have on exactly how we perform this process.
Darilyn Cole, RN CRNI VA-BC
Darilyn Cole, RN, CRNI, VA-BC
PICC Team Mercy General Hospital Sacramento, CA
Dale,
Do you mind sharing that time and motion study. This is definitely helpful in benchmarking our data with anyone else who has done the same. Thank you.
Mercedes McCoy, CRNI
Hi Darilyn -
We would also love to see your time and motion study. Please e-mail to [email protected].
Thank you!!
Keely
Keely Ralston RN-BC, VA-BC, CPUI, RCIS
Could you send me the reference/ Joint Commission regulation regarding the observer and central line placement ?
Thanks,
Dave B
[email protected]
David Bruce RN