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SRT PICC
HOW WE DO IT
References
INFUSION NURSES SOCIETY
• 2011 Infusion Nursing Standards of Practice
References
CENTRE FOR DISEASE CONTROL
Guidelines for the Prevention of Intravascular
Catheter-Related
Infections, 2011
MEMORY AID
• Wash Your Hands First
• Use Body Fluid Precautions
• Aseptic Care Of The Vascular Access Devices
• The Fluid Pathway Must Remain Sterile
• All Cleaning Solutions Must Be Allowed To Dry
• Catheters Must Be Secured
• Do Not Remove A PICC
WHAT IS A PICC
WHAT IS A PICC
WHAT IS A PICC
WHAT IS A PICC
WHAT IS A PICC
WHAT IS A PICC
ASEPSIS
• Medical Asepsis
– clean: reduce and prevent spread of
microorganisms
– sterile: aim to eliminate microorganisms
• Surgical Asepsis
FLUSH THE CATHETER
• ASSESS CATHETER PATENCY
• BLOOD RETURN
• FLUSHES FREELY
FLUSH THE PICC
1. Wash your hands first.
2. Use body fluid precautions.
3. Aseptic care of vascular access devices.
4.The fluid pathway must remain sterile.
5. All cleaning solutions must be allowed to dry
completely.
6. Catheters must be secured.
7. Do NOT remove a PICC.
FLUSH THE CATHETER
• FIBRIN SHEATH
FLUSH THE CATHETER
FLUSH THE CATHETER
MALPOSITION
MALPOSITION
FLUSH THE PICC
• The Infusion Nursing Standards of Practice establishes
the national standard for all infusion therapy.
• This standard on flushing emphasizes the goals of
maintaining patency and preventing contact between
heparin and incompatible solutions.
• The standard incorporates the concepts of catheter
flushing and locking. Flushing assesses catheter
patency and functionality and removes the previously
infused medication. Locking the catheter creates a
closed column of fluid inside the catheter lumen
intended to prevent blood from moving into the
lumen. (IV)
FLUSH THE PICC
• SASH Saline Admixture Saline Heparin
• Lock non-valved catheters with positive
pressure.
FLUSH THE PICC
• Vascular access devices shall be flushed prior to each
infusion as part of the steps to assess catheter function
• Vascular access devices shall be flushed after each
infusion to clear the infused medication from the
catheter lumen, preventing contact between
incompatible medications.
• Vascular access devices shall be locked after
completion of the final flush solution to decrease the
risk of occlusion. (IV)
• SASH Saline Admixture Saline Heparin
PICC SKIN CLEANING SOLUTIONS
• >.5% Chlorhexidine
• Povidone-iodine
• 70% Alcohol
DRESS THE PICC
• Wash Your Hands First
• Use Body Fluid Precautions
• Aseptic Care Of The Vascular Access Devices
• The Fluid Pathway Must Remain Sterile
• All Cleaning Solutions Must Be Allowed To Dry
• Catheters Must Be Secured
• Do Not Remove A PICC
DRESS THE PICC
• Replace transparent dressings used on
tunneled or implanted CVC sites no more than
once per week (unless the dressing is soiled or
loose), until the insertion site has healed.
• Replace catheter site dressing if the dressing
becomes damp, loosened, or visibly soiled
• Replace dressings used on short-term CVC
sites every 2 days for gauze dressings. (CDC)
DRESS THE PICC
• Remove the old dressing in the direction of
the insertion site to avoid pulling out the
catheter.
• Secure the catheter.
• Work from clean to dirty.
• Clean everything that will be under the new
dressing, skin and catheter
DRESS THE PICC
DRESS THE PICC
1. Wash your hands first.
2. Use body fluid precautions.
3. Aseptic care of vascular access devices.
4. The fluid pathway must remain sterile.
5. All cleaning solutions must be allowed to dry
completely.
6. Catheters must be secured.
7. Do NOT remove a PICC.
SECURE THE PICC
• Use a suture less securement device to reduce
the risk of infection for intravascular catheters
[105]. Category II
DO NOT REMOVE THE PICC
1. Air Embolism
2. Syncope
3. Venous Spasm
4. Catheter Fracture
VENOUS SPASM

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Srt how picc

  • 2. References INFUSION NURSES SOCIETY • 2011 Infusion Nursing Standards of Practice
  • 3. References CENTRE FOR DISEASE CONTROL Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2011
  • 4. MEMORY AID • Wash Your Hands First • Use Body Fluid Precautions • Aseptic Care Of The Vascular Access Devices • The Fluid Pathway Must Remain Sterile • All Cleaning Solutions Must Be Allowed To Dry • Catheters Must Be Secured • Do Not Remove A PICC
  • 5. WHAT IS A PICC
  • 6. WHAT IS A PICC
  • 7. WHAT IS A PICC
  • 8. WHAT IS A PICC
  • 9. WHAT IS A PICC
  • 10. WHAT IS A PICC
  • 11. ASEPSIS • Medical Asepsis – clean: reduce and prevent spread of microorganisms – sterile: aim to eliminate microorganisms • Surgical Asepsis
  • 12. FLUSH THE CATHETER • ASSESS CATHETER PATENCY • BLOOD RETURN • FLUSHES FREELY
  • 13. FLUSH THE PICC 1. Wash your hands first. 2. Use body fluid precautions. 3. Aseptic care of vascular access devices. 4.The fluid pathway must remain sterile. 5. All cleaning solutions must be allowed to dry completely. 6. Catheters must be secured. 7. Do NOT remove a PICC.
  • 14. FLUSH THE CATHETER • FIBRIN SHEATH
  • 19. FLUSH THE PICC • The Infusion Nursing Standards of Practice establishes the national standard for all infusion therapy. • This standard on flushing emphasizes the goals of maintaining patency and preventing contact between heparin and incompatible solutions. • The standard incorporates the concepts of catheter flushing and locking. Flushing assesses catheter patency and functionality and removes the previously infused medication. Locking the catheter creates a closed column of fluid inside the catheter lumen intended to prevent blood from moving into the lumen. (IV)
  • 20. FLUSH THE PICC • SASH Saline Admixture Saline Heparin • Lock non-valved catheters with positive pressure.
  • 21. FLUSH THE PICC • Vascular access devices shall be flushed prior to each infusion as part of the steps to assess catheter function • Vascular access devices shall be flushed after each infusion to clear the infused medication from the catheter lumen, preventing contact between incompatible medications. • Vascular access devices shall be locked after completion of the final flush solution to decrease the risk of occlusion. (IV) • SASH Saline Admixture Saline Heparin
  • 22. PICC SKIN CLEANING SOLUTIONS • >.5% Chlorhexidine • Povidone-iodine • 70% Alcohol
  • 23. DRESS THE PICC • Wash Your Hands First • Use Body Fluid Precautions • Aseptic Care Of The Vascular Access Devices • The Fluid Pathway Must Remain Sterile • All Cleaning Solutions Must Be Allowed To Dry • Catheters Must Be Secured • Do Not Remove A PICC
  • 24. DRESS THE PICC • Replace transparent dressings used on tunneled or implanted CVC sites no more than once per week (unless the dressing is soiled or loose), until the insertion site has healed. • Replace catheter site dressing if the dressing becomes damp, loosened, or visibly soiled • Replace dressings used on short-term CVC sites every 2 days for gauze dressings. (CDC)
  • 25. DRESS THE PICC • Remove the old dressing in the direction of the insertion site to avoid pulling out the catheter. • Secure the catheter. • Work from clean to dirty. • Clean everything that will be under the new dressing, skin and catheter
  • 27. DRESS THE PICC 1. Wash your hands first. 2. Use body fluid precautions. 3. Aseptic care of vascular access devices. 4. The fluid pathway must remain sterile. 5. All cleaning solutions must be allowed to dry completely. 6. Catheters must be secured. 7. Do NOT remove a PICC.
  • 28. SECURE THE PICC • Use a suture less securement device to reduce the risk of infection for intravascular catheters [105]. Category II
  • 29. DO NOT REMOVE THE PICC 1. Air Embolism 2. Syncope 3. Venous Spasm 4. Catheter Fracture