Transcript CVAD Care and Maintenance

PICC Line Care and Maintenance
Preview…….just a taste of what
we can offer you and your
facility!
Vascular Access Plus
(402) 449-9330
[email protected]
PICC Line Care and
Maintenance
Vascular Access Plus
Jamie L. Hamm RN, BSN
Vascular Access Specialist
Learning Objectives
• Verbalize and Demonstrate how to change a PICC line
dressing
• Verbalize and Demonstrate how to change a needleless
injection cap
• Verbalize and Demonstrate how to scrub the hub
• Verbalize and demonstrate how to perform PICC line
measurements
• Verbalize and Demonstrate how to document PICC line
care
• Verbalize and Demonstrate how to assess your
patient’s PICC line
Vascular Access Review
• What is a PICC line?
• Who can change a PICC
line dressing and
needleless injection cap
in my facility?
• Who can perform a
PICC line assessment in
my facility?
• Who does the
documentation?
• How is a central line
different than a PICC
line?
• What do these initials
stand for?
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INS
ONS
JACHO
ENOA
AVA
VAP
PICC line Dressing Change
ASSESS THE PATIENT
• Does my patient still need
the PICC line?
• What are the previous
measurements for my
patient?
• Do I have an insertion
record?
• Do I need two nurses to
change the PICC dressing?
GATHER SUPPLIES
• Central Line dressing
change kit with CHG, mask,
and sterile gloves
• Securement device
(StatLock or Shield)
• Non-sterile gloves
• Antibacterial hand gel or
soap and water
• Tape Measure
• BioPatch
SHIELD
Now you are ready to change the
dressing at the patient’s bedside…
1. Set up your sterile field and position your patient’s arm. Use a piece
of tape to hold the PICC in place on the arm if needed.
2. Wash your hands and put on non-sterile gloves and remove old
dressing and discard gloves. Re-wash your hands.
3. Put on sterile gloves. Use CHG and cleanse the patient’s skin with
FRICTION for a minimum of 30 seconds. DON’T FORGET TO WASH
UNDER THE PICC LINE AND AN EXTENDED AREA 3+ INCHES
AROUND). Let Air Dry.
You Can keep one hand sterile and one hand non-sterile OR
You can use gauze to maintain sterility of both hands during cleaning
4. Place the BioPatch on if available.
5. Place Shield dressing or StatLock for securement.
Cover all the PICC line past the junction and securement of the hub.
Where is the hub?
There
are 2
Hubs…
Where
is the
2nd Hub
to
Scrub?
“SCRUB THE HUB”
“SCRUB THE HUB”
What are the parts of a PICC line
measurement?
1. Total Length of the PICC line on insertion
You need the insertion record
2. External Length sticking out of patient
Done Daily and prn
3. Arm circumference 3 inches above the
insertion site and arm circumference is
measured in cm around the arm
Done Daily and prn
External Length
This is the
Junction. Your
external
measurement
starts here.
Between each dot = 1cm
(use your fingertip)
Total Catheter Length
• The total length of a
Power PICC solo
catheter is 55cm total
• You need to know the
total catheter length
before removing your
patient’s PICC
line…….how do you
know you got it all out?
Note how the PICC line
starts with 0 instead of 1
Troubleshooting 101
• If you do not have a blood return
then you have a non-functioning
vascular access device…STOP and call
Vascular Access Plus for
troubleshooting guidance at
(402) 449-9330
Does my patient still require a PICC
line?
 How many days are left to complete the infusion
therapy?
 Are we just keeping the PICC line to have IV
access?
 Was the PICC line difficult to place?
 Did the physician want the PICC line removed
when therapy ended?
 Are there signs of infection at the insertion site?
 Does my patient have a non-functioning access?
Should my patient have a PICC line?
 CDC 2011 recommends a Midline or PICC line for
any infusion therapy duration >6 days
 If your patient requires more than 3 peripheral IV
starts for the IV therapy, you will cost your
facility/patient as much as putting in PICC line.
 What type if infusion therapy is ordered? INS
recommends a PICC line for any drug with a pH
<5 or greater than 9.
 Have I attempted peripheral IV access prior to
requesting a PICC line? Should I attempt
peripheral IV access before I call the PICC nurse?
There is sooooooo much more!
Call Today and book your
educational CEU event for your
staff!
(402) 449-9330