A variety of skills are brought to bear on a daily multiple patient regimen, but nurses may need some more than others at critical junctures in the patient’s care plan. The most valuable skill a nurse can get trained on is opening a pick line in a patient. This is often referred to as finding a vein, or setting up a PICC line. The necessity for keeping the “pick” line in for every patient is a requirement for institutionalized healthcare practices and sound care plan advice.
The tap-in should be clean and free from swelling, tension, stiffness,’and/or causing discomfort for the patient. Blood, water, liquid of any type collecting under the dressing should be examined at once. Once affixed, tapes should be annotated with the date of line-in for future reference. Finding peripheral lines in veins must accord with circulatory norms. Nurses cannot begin to rely on easy veins and many long-term patients will need the best pick line insertion techniques when their pick line sites will begin to dry up.
The PICC line is not an easy skill to master. Connecting with the Superior Vena Cava is essential, and thus not just “any” vein can be used. In long term patients the proper veins ”hide” or “become smarter”, evading nurse’s or a technician’s search. This the need for mechanized equipment to find the proper vein is often required. A sonogram machine can be used to generate a visualization of the vein location for technical insertion point.
Nurses categorically check the line on every patient they have in their care roster, whether they are on IV drugs or not. Infection can start if a pick line is left in for too long. This is due to the procedural adaptation in every patient’s medical status whereby IV drug therapy becomes necessary. Grooming a patient’s line and monitoring its condition must be done at all times. Re-insertion of the line must be performed at once if problems arise.
Yet time and again the need for a re-insertion of a patient’s line can shed light on just how few nurses on the ward, if any, can find a vein and insert the pick line in a manner which will be sustained over a number of days. Patients may pull the line out, loosen it, or even worse, injure themselves. Nurse should explain to patients why they need to be conscientious about their line and work towards not straining it or causing tears at the skin’s opening.
This is a serious problem and could cause further delays and inefficiencies in nursing care down the line. Hunting through various staff wards for a nurse who can insert a pick line without the assistance of a sonogram is a seriocomic statement of what training nurses are expected to have versus what the actually bring to the job each day. Nurses should note in their charts the condition if each pick line and notify patient services if additional assistance is required.
Of course the heplock can always be used but that required a clean set of tubes every 72 hours and a clean insertion site. Many patients do not have the skin integrity or the vein strength for this. For this reason the PICC line is favored. To avoid delay in adminitrating an ordered dosage or maintenance regimen of material, make sure the entire case history of the patients dermal integrity is reviewed before any perforation is commenced.