Performance criteria statlock picc dressing performance criteria securacath picc dressing performance criteria every 96 hours needleless connector change picc removal demonstration checklist definitions for the purpose of this policy and procedure. Picc line dressing change with biopatch and griplock griplok duration. Document the dressing change, the appearance of the insertion site, and your patients response. This article describes a neonatal picc dressing change and discusses the frequently encountered quandaries surrounding this important procedure, including dressing materials. Explains the procedure to patient and places a mask on patient.
Peripherally inserted central catheter picc a picc is a special intravenous iv catheter that is soft. Use transfer forceps to add sterile supplies wear nonsterile gloves to remove old dressing perform hand hygiene, then don sterile gloves for. Place sterile gauze just above insertion site, to have ready to apply pressure when catheter is removed. It takes training and practice to change a picc dressing. If present, call your nurse or clinician after finishing the dressing change procedure. Remove old stabilization dressingsecurement device. Dressing change for picc or cvc 07remove dressing by pulling towards the insertion site.
Peripherally inserted central catheter 7 how do i change a picc line dressing. Sterile dressing change procedure updated february 20 duration. Peripherally inserted central catheter picc a picc is a soft, flexible catheter inserted into a vein in your arm by either a nurse at the. One of the things you will encounter as a nurse is a picc line also called a peripherally inserted central catheter. Document the picc dressing change, clinical assessment of site and. Central venous access device dressing change procedure ahrq. Purpose this guideline has been developed as part of the icare intervention bundle for the management of intravascular devices ivds. Removing an old dressing, cleansing a wound, applying a dry sterile dressing.
Learning objectives discuss components of the central venous catheter cvc maintenance bundle outline issues to address during the transition of. Aarp health insurance plans pdf download medicare replacement pdf download medicare benefits pdf download medicare part b pdf download cpt code picc line care dressing change. A peripherally inserted central catheter picc is a long, thin tube that goes into your body through a vein in your upper arm. Explain the procedure to the patient and have the patient turn hisher head away from the catheter insertion site. Prepare the transparent dressing by removing the paper on the back and flatten the dressing by gently pulling it taut. Policy and procedure for picc line or midline catheter dressing change purpose. Regular dressing and cap change as per hospital policy soiled or wet dressing changed asap bloodstained dressings changed asap damaged catheters should be replaced asap. Nonsterile gloves one pair alcohol pads to remove old dressing as needed sterile dressing change kit. We recommend you check out their step by step picc line dressing guide with illustrations. Dont use any ointments at a peripherally inserted central catheter picc insertion site. Picc line midline catheter skills checklist mcnwf007, r3 2014 page 2 of 2 check proficiency 1 2 3 4. Do not touch the picc insertion site and the surrounding area while the dressing is off.
After the first 24 hours the frequency is every seven days. Cover site with sterile transparent dressing, making sure to cover the extension set. Sutures on tunneled lines should be removed from the insertion site in 1014 days and exit site in 68 weeks. This video shows how to change a picc line dressing. The best way to learn is to practice as much as you can while your child is in the hospital. Tell your doctor if you do not have someone to help with your dressing change. Leaves patient in a comfortable, safe position safety checks with call light within reach. Peripherally inserted central catheters piccs page 6 of 12 3. This is a video tutorial on how change a picc dressing. Policy and procedure for picc line or midline catheter. Home health agency billing, instructions specify that for each claim, hhas irrigation, packing, and dressing twice each day.
The needs, risks and benefits of dressing changes should be considered because the procedure is not without risk and may cause discomfort or trauma to fragile skin. Obtains sterile central line dressing kit and mask for patient. At this hospital we also charge the same for a midline as a picc although we would never do a midline on. The picc will require a weekly flush with 10mls of sterile 0. A properly applied and maintained picc dressing is the first line of defense to minimize the risk of complications such as dislodgement, migration, and infection.
The picc is a central vascular access device inserted via a peripheral vein above the antecubital fossa e. The end of this catheter goes into a large vein near your heart. Information for flushing and dressing an openended picc. Refer to vad policy, dressing changes, for frequency of dressing changes and options for types of dressing. Change securement devices on a regular base as per hospital policy. Procedure checklist changing central iv dressings check. Simulation training of catheter insertion procedures including infection prevention strategies. Position patient for comfort and ease of access to catheter. To learn the skills necessary to change a peripherally inserted central catheter picc dressing and be able to. Places patient in a semifowlers position if tolerated.
The needs, risks and benefits of dressing changes should be considered because the procedure is. Antibacterial ointment may actually increase colonization of fungi. Maintenance and removal of central venous catheters. Central venous access device dressing change protocol. The last hospital i worked at charged the same for a midline as a picc. Procedure to patient catheter management to patient obtain signed consent form picc line only. To prevent external infection of the peripheral or central venous catheter frequency. Assemble equipment and supplies on clean work surface. If patient cannot tolerate a mask, directs him to turn his head to the opposite side from the insertion site. Does anyone charge separately for cvcpicc dressing change. Py2019 comprehensive primary care plus payment methodologies.
Remove securement device making sure picc line stays in place. Perform dressing change as needed per patient or external indications. The picc in this video is a double lumen picc with a stat lock. Write date changed on tubing change sticker and attach to tubing. Jan 14, 2014 cms does not construe this as a change to the mac statement of work. Patient should be recumbent in bed apply slow, steady traction when sliding catheter out have patient perform valsalva maneuver place petroleumbased ointment, a sterile gauze, and occlusive dressing over insertion site.
Sterile technique must be used for picc dressing change. Changes in patient position impact catheter tip location and depth. Discontinuing a picc o physicianprovider order required to discontinue picc o procedure highlights. Infusion therapyinsertionaccess procedures position statement for rn, lpn and uap practice page 1 of 2 north carolina board of nursing po box 2129 raleigh, nc 27602 919 7823211 fax 919 7819461 nurse aide ii registry 919 7827499. Clinical trials havent established their effectiveness. Dons mask and clean procedure gloves and carefully removes the old dressing by lifting and removing tape in the direction of the catheter insertion. Central venous access devices dressing change approved by npc 05172012 3 10. The guideline will promote a consistent and standardised approach to management of picc.
This guideline describes the procedure for performing a dressing change for a peripherally inserted central catheter picc that is secured with an adhesive securement device. Assess the dressing in the first 24 hours change for accumulation of blood fluid or moisture beneath the dressing. Only nursing personnel who have demonstrated competency may perform a central vad dressing change. You or a family member may be able to do the dressing change at home. Picc peripherally inserted central catheter removal. Picc peripherally inserted central catheter removalactionrationale 051020lm page 2 working outward, allow to air dry for approx.
It is a little cheaper for the patient because they dont pay for an xray or the reading of an xray. Or you may be instructed to return to the office or clinic for dressing changes. If your dressing is changed at home, be sure you or your family member knows sterile dressing technique. Peripherally inserted central catheter dressing change. Use this pictureperfect technique to protect your patient. Central line dressing changes apply 4 moments of hand hygiene don cap, gown and mask with face shield included in dressing tray prepare tray aseptically. Guideline for peripherally inserted central venous catheters picc. Contact radiology confirm catheter tip position and reposition. Upon first entering the patients room, disinfect your hands by washing with soap. At home you will need to change the dressing that protects the catheter site. Look around the picc site for swelling, redness, tenderness or drainage. If drainage is present, cover site with a sterile gauze dressing under the transparent dressing for 24 hours.
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