Page 1 of 25 DESCRIPTION/OVERVIEW The purpose of this ...

More documents

Recommendations

Info

Resource/Dept Sheena Ferguson, RN, MSN, CNS, Clinical Education, Interim Chief Nursing Officer Jo Anne Wright, RN, MSN, CNS Pediatrics Internet/Link DOCUMENT APPROVAL & TRACKING Item Contact Date Approval Owner Clinical Education Department Jo Anne Wright, RN, MSN, CNS, Pediatric Specialty Care Unit Sherman Henderson, RN, BSN, PICC/Conscious Sedation Team Rebecca Mc Kernan, RN, MSN, APN, Pediatric ENT Consultant(s) Ninon Adams, RN, Pediatric General Surgery Cathy Chavez, RN, BSN, Pediatric Oncology, Research Nurse Shirley Mc Graw, RN, BSN, MBA, Unit Director, PACU Committee(s) NCOC Policy and Procedure Subcommittee Nursing Clinical Operations Council Nursing Officer Sheena Ferguson, Interim Chief Nursing Officer Y Medical Director/Officer NA Human Resources NA Finance NA Legal NA Official Approver Sheena Ferguson, Interim Chief Nursing Officer Y Official Signature 2 nd Approver (Optional) Signature Effective Date 07/27/05 Origination Date 08/2002 Issue Date Clinical Operations Policy Coordinator 07/27/05 Y ATTACHMENTS Attachment A: Long Arm Catheter (LAC) Insertion Attachment B: Removal of a Long Arm Catheter (LAC) Attachment C: Long Arm Catheter Length Selection Attachment D: Care of the Pediatric Central Catheters Attachment E: Venous Access Port Addendum Attachment F: Care of the Adult Central Catheters Attachment G: Quick Reference for VADs Attachment H: Care for the VAD in the Post Anesthesia Care Unit (PACU) _________________________________________________________________________________________________________________ Title: Venous Access Device Owner: Clinical Education Department Effective Date: 07/27/05 Page 6 of 25
ATTACHMENT A: LONG ARM CATHETER (LAC) INSERTION 1. The LAC qualified Registered Nurse collaborates with the physician to identify patients who may benefit from LAC placement. 2. A physician's order is secured indicating the desired placement of the catheter tip. 3. The patient and/or family is provided with information as to the indications, risks, benefits, and care that a LAC placement entails, as well as, the possibility that placement may not be successful. 4. Assessment of the veins is completed with the identification of the basilic, median antecubital, and cephalic veins. The brachial artery is also palpated. The decision to proceed is made if the patient is a candidate and if informed written consent is obtained. A consent form is not required with a midline placement. 5. The patient is assessed for medical conditions or medications that may be a contraindication for LAC placement. Examples: sepsis, A-V fistulas, Coumadin, uncontrolled hypertension. Any concerns that the RN may have with regard to potential contraindications must be brought to the attention of the physician. 6. Medication allergies must be checked. EMLA may be placed per policy and procedure. If an allergy to EMLA or Lidocaine exists, consult with the patient's nurse for alternative medications per physician's orders. 0.9% Sodium Chloride (NaCl) may be used as the preservative acts as an anesthetic. 7. Place the patient in a recumbent position to facilitate venous filling of the dependent extremity. A three-minute scrub from hands to elbow area is done. 8. The RN measures the patient for the desired length of the catheter using the non-sterile tape measure with the patient's arm at a ninety-degree angle from the body. 9. The RN also measures the upper arm circumference midway between the shoulder and the elbow. 10. The RN dons personal protective equipment to include hat, mask, sterile gloves, and a yellow gown in setting up the LAC field with the contents of the tray and other necessary supplies. The patient should wear a mask, but may be omitted if the patient is unable to tolerate it. 11. The skin is prepped using chlorhexidine swabsticks using a scrubbing motion back and forth. Allow the chlorhexidine to dry. 12. Depending on which kit is utilized; two or three drapes are placed for maximal protection of the field and to allow the catheter to uncurl. Take the second tape measure (sterile) from the tray and position it in such a way that the catheter may be straightened onto it using the _________________________________________________________________________________________________________________ Title: Venous Access Device Owner: Clinical Education Department Effective Date: 07/27/05 Page 7 of 25
Page 1 and 2: Applies To: All HSC Hospitals, CRTC
Page 3 and 4: 12. Patient Education 12.1. Instruc
Page 5: KEY WORDS Broviac Catheter, Central
Page 9 and 10: 22. Clean and apply a dressing to t
Page 11 and 12: ATTACHMENT C: LONG ARM CATHETER LEN
Page 13 and 14: ATTACHMENT D: CARE OF PEDIATRIC CEN
Page 15 and 16: CARE OF PEDIATRIC CENTRAL CATHETERS
Page 17 and 18: CARE OF PEDIATRIC CENTRAL CATHETERS
Page 19 and 20: ATTACHMENT F: CARE OF ADULT CENTRAL
Page 21 and 22: Type of Lines Irrigation: use Hepar
Page 23 and 24: ATTACHMENT G: QUICK REFERENCE FOR V
Page 25: ___________________________________

Page 1 of 25 DESCRIPTION/OVERVIEW The purpose of this ...

Create successful ePaper yourself

Delete template?

Save as template?