PICC Line Care and Maintenance Preview…….just a taste of what

we can offer you and your facility!

Vascular Access Plus(402) 449-9330

info@vascularaccessplus.com

PICC Line Care and Maintenance

Vascular Access PlusJamie 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?– 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 ORYou 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?

“SCRUB THE HUB”There are 2 Hubs…Where is the 2nd Hub to Scrub?

“SCRUB THE HUB”

What are the parts of a PICC line measurement?

1. Total Length of the PICC line on insertionYou need the insertion record

2. External Length sticking out of patientDone Daily and prn

3. Arm circumference 3 inches above the insertion site and arm circumference is measured in cm around the armDone Daily and prn

External Length

Between each dot = 1cm(use your fingertip)

This is the Junction. Your external measurement starts here.

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