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PICCs

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This course contains the skill check-off lists for the skills associated with providing infusion therapy via a PICC, these skills are completed with a preceptor. These competency requirements are obtained and maintained through the nurse’s employer, facility, or institution, via their designated preceptor. Each State Board of Nursing may have varying positions on the role of the LPN/LVN in the administration of infusion therapy via central lines, and removal of PICCs. Each nurse will need to verify the rules within their own state's scope of practice. 

 

Objectives

Upon completion of this course, the participant will be able to:

  1. Distinguish a peripherally inserted central catheter (PICC) from other types of central venous access devices.
  2. Describe the procedure for each maintenance task of PICC care.
  3. State at least 3 potential PICC complications, prevention and treatment.

 

Curriculum

 

Chapter 1: PICC Description

  • CVAD definitions and terminology used
  • Indications and Contraindications
  • Anatomy and Physiology
  • Tip placement

Chapter 2: Assessment and Preparations for PICC

  • Assessment Criteria for Insertion of a PICC
  • Preparations for PICC insertion
  • Education of Patient and Caregiver

Chapter 3: Infusion Product Review and Maintenance Guidelines

  • Needleless Connectors
  • Passive Disinfection Caps
  • Filtration
  • CVAD Stabilization
  • Site Protection
  • Flushing
  • Locking
    • Pediatrics
    • Antimicrobial locking solutions
  • SASH
  • Assessment/Tracing
  • Dressing Changes
  • Administration Set Change
    • Primary and Secondary Continuous Infusion
    • Primary intermittent infusion
    • Parenteral Nutrition
    • Blood/Blood Component
  • Blood Sampling from a PICC

Chapter 4: PICC Care Procedure and Videos

  • PICC Dressing Change
  • Central Venous Catheter Needleless Access Device Change
  • Central Venous Catheter Flushing and Locking
  • Blood Sampling from a CVAD- Discard Method
  • PICC Occlusion Clearing

Chapter 5: Complications

  • Phlebitis
    • Chemical
    • Mechanical
    • Bacterial
  • Central Vascular Access Device Occlusion
    • Thrombotic Occlusion
    • Mechanical Occlusion
    • Medication/Lipid Precipitate Occlusion
  • Bleeding/Hematomas
  • Infiltration/Extravasation
  • Site Infection/Catheter Related Bloodstream Infection (CRBSI) or Septicemia
  • Catheter Damage/Embolism
  • Venous Air Embolism
  • Tip Malposition
  • Medical Adhesive Skin Related Injury or MARSI
  • Nerve Injury

Chapter 6: Documentation, Discontinuation of Therapy

  • Discontinuation of therapy
  • PICC removal
Chapter 7: References
  • California Bill 241
  • Implicit Bias in Healthcare
  • What is Implicit Bias?
  • Implications of Implicit Bias in Healthcare
  • How to Reduce Implicit Bias