PICC Excellence, Inc.

Early bird registration is open for the 2025 Infusion Nurses Society Annual Meeting in Las Vegas! We enjoy meeting our colleagues, sharing our courses with attendees and learning from their professional experiences. Sign up: https://lnkd.in/etpW56DJ

QUESTION Are you applying locks (KiteLock, Taurosept, Alteplase) via needle free connectors (NFC) or without? Is NFC affected by the lock? And what kind of prefilled syringes do you use in your institution - we have BD posiflush. ANSWER When performing a lock or declotting procedure it is acceptable to do it with or without a needle free connector (NFC). The NFC is not affected by the lock, however, changing the NFC before the instillation may have the advantage of avoiding any bacterial shower that could come from the blood adhering to the NFC.? Many different types of prefilled syringes are available. The BD posiflow syringes are more expensive because they have the feature that eliminates the rebound of the plunger thus reducing that blood reflux occurring when the plunger bottoms out as it empties. Any type of prefilled syringe can be used if the user stops before fully emptying or bottoming out. I refer you to articles on prefilled syringes and features for greater understanding.

Is it time to renew your CPUI or CNPI certification? ?? Check the registry to see when yours expires. https://lnkd.in/eKS6S2uY

Plan ahead for next year's learning with multi-user access! Choose an area to focus on like ultrasound guided PIV, or pediatric, adult or neonatal PICC. Multi-user access ensures everyone on your team receives the same education. https://lnkd.in/e4ZPg23X

Nurse practitioners are a valuable link between physicians and patients. We celebrate their contributions during National Nurse Practitioner Week November 10-16! #npweek

Sign up for the next session of our acclaimed ultrasound-guided peripheral IV therapy workshop! We still have some space in the December 10 workshop in Greenville. https://lnkd.in/epFpV-zx

With IV fluid shortages affecting many facilities, one-stick accuracy in vascular access is more important than ever. Hone your skills with our ultrasound guided peripheral IV Therapy Mastery Learning program. https://lnkd.in/ezZzE_h8

It feels like we just left Denver after this year's AVA annual meeting, but it's time to start planning for 2025! As vascular access professionals, we learn from the experiences of our peers. If you have an interesting case or a topic you want to present at the next AVA annual meeting, submit your proposal by November 17. www.avainfo.org/cfp2025? If you have a suggestion for a speaker or topic but don't want to present, you can share that too! https://lnkd.in/ezBke4jE

Get hands-on training with a one-day workshop for ultrasound-guided peripheral IV (UGPIV) therapy in Greenville, SC on December 10. At the end of the workshop, you will have completed the demonstration component required for the UGPIV Mastery Certificate and will be ready to take your mastery certificate exam. https://bit.ly/3SjOIri

How long can a PICC stay in place? We have a patient with a 2-year old PICC line that still looks good and is working, but I'm concerned about the integrity of the catheter itself. Does it need to be removed at a certain length of insertion? Dr. Moureau's Answer: The issue of optimal dwell time for intravenous devices applies to the catheter material, the FDA submission category, the manufacturer's instructions for use (as submitted to the FDA), the recommendations of the Centers for Disease Control, and the Standards from the Infusion Nurses Society. Long-term (greater than 30 days) and short-term (up to 29 days) are classifications used for biocompatible materials such as polyurethane catheters. Materials used for intravascular catheters are all considered biocompatible and suitable for long-term dwell. The CDC guidelines state, "Replace midline catheters only when there is a specific indication" and "Do not routinely replace CVCs, PICCs, hemodialysis catheters, or pulmonary artery catheters to prevent catheter-related infections." The 2024 INS Standard 42 Vascular Access Device Removal states for Short and Long Peripheral Catheters, "Remove PIVCs and midline catheters in pediatric and adult patients when clinically indicated, based on findings from site assessment and/or clinical signs and symptoms of systemic complications and not solely on dwell time."? There is no evidence establishing optimal dwell time for intravenous catheters. Current evidence indicates no value in scheduled replacement with removal only when clinically indicated by a complication or completion of therapy. In most clinical settings average dwell time of a PICC is 10-14 days. The longest dwelling PICC without complications on record is from MD Anderson Cancer Center at 7 years. Removal of the PICC was performed when a complication developed. In summary and in answer to?your question, a 2-year-old PICC without complications is acceptable as long as therapy continues, the device is suitable for the patient and treatment plan, if there is still a need for a central VAD, and there are no concerns over the development of complications such as infection, thrombosis, or other. A PICC line can stay in as long as it is needed, this can be weeks or months or years.