Policy Manual sample

MDT Home Health Care Agency, Inc. 106 REMOVAL OF PICC LINES PURPOSE: The removal of a PICC line should be performed in accordance with physician’s orders by a Registered Nurse. The registered nurse should notify the physician promptly if any difficulties are encountered upon removal. The catheter should be inspected for any damage upon removal. PERSONNEL RESPONSIBLE: RN EQUIPMENT: • Tourniquet • Sterile 2 x 2 or 4 x 4’s • Gloves • Sterile gauze dressing • Antiseptic ointment PROCEDURE: 1. Explain procedure to patient. 2. Wash hands. 3. Don gloves. 4. Remove dressing, moving from the hub toward the insertion site to avoid dislodgement. 5. Remove sutures if applicable. 6. Grasp the catheter with thumb and forefinger and begin to remove in 1 inch bites with a smooth and consistent motion. 7. Do not remove too quickly or too slowly. 8. When catheter is out, place pressure on site until bleeding stops. 9. Apply ointment to site to potentially occlude the skin tract and prevent air embolism. Change dressing and have patient and/or family assess site every 24 hours until healed. Teach patient/family to notify physician for any redness, drainage or swelling around insertion site. 10. Apply sterile gauze dressing. 11. Observe the tip for damage or fracture. 12. Remove gloves and dispose of equipment. 13. Wash hands. TROUBLESHOOTING: Stuck catheter is defined as resistance to removal. Incidence of occurrence is less than one percent (1%). CAUSES: • Most common cause is venospasm • Fibrin formation • Thrombosis • Knot in catheter PREVENTION: • Remove catheter slowly in small increments • Do not apply pressure at or near the insertion site or along the course of the vein during removal • Do not force if resistance is encountered SIGNS AND SYMPTOMS: • Unable to remove catheter • May visually see the vein in spasm