PICC Lines: Benefits of RN Placement
When it comes to PICC line placement, many facilities are still using Interventional Radiology (IR) suites to initiate this type of central line access. However, current research reveals that Peripherally Inserted Central Catheters (PICCs) do not need to placed by Radiologists in order to bring benefits to patients.
Increasingly, Registered Nurses (RNs) trained and certified in PICC line placement can perform this procedure at the bedside with lower costs and equally beneficial outcomes.
What Are The Benefits of Bedside PICCs Placed By RNs?
According to recent research, RNs are increasingly being used as a safe, efficient and cost effective way to provide patients with vascular access by placing PICC lines at the bedside, instead of facilities sending those patients to IR. In most healthcare facilities, IR departments are already saddled with numerous procedures, and PICC line placements often fall to the lowest priority. This means that patients with difficult vascular access needs may end up with delays in needed therapy, simply because IR teams cannot keep up with the demands being placed upon them.
Here is where the PICC nurse comes in. Not only have bedside placements been shown to “add efficiency to an overwhelmed interventional radiology department…” they have also been shown to “…reduce costs and procedure delays for the patient.” (Jenkins, 2009)
According to the study conducted by Jenkins, PICC line placements performed by properly trained nurses cost a fraction of traditional IR line placements and free up interventional radiology departments and physicians to perform the critical care procedures they are uniquely qualified for. 
In addition to reducing workload on physicians and cost reduction, bedside PICC placements have been shown to reduce the time from when a medication is ordered to first dose being received. This is the direct result of PICC teams being able to place lines in less time than it takes for IR to free up a suite for the same procedure.
In one study, the decrease in time from when a PICC line was ordered to when it was placed decreased from a mean of 34 hours for IR PICC placement to 6 hours with a RN led PICC team (Conlin, et.al., 2019) placement. When it comes to a septic or hemodynamically unstable patient, delays in IV therapy can significantly contribute to mortality and morbidity.
Additionally, in patients for whom transfer may be difficult or dangerous, the use of a bedside PICC nurse offers a patient centered way to achieve optimal outcomes without undue risk to patients. The use of ECG technology also reduces the need for patients with PICC lines to undergo radiographs post procedure, as tip location can be verified and confirmed in real time.
CLABSI rates among PICCs placed by a bedside nurse are comparable (and even lower in some studies) to those rates for PICCs placed in IR, indicating that safety is not compromised by RN placements (Conlin, et.al., 2019). Success rates are also comparable between RN and IR placed catheters, indicating >95% success of RN led PICC teams in the studies referenced in this article.
Ultimately, the authors found that the addition of RNs trained to perform bedside PICC services “…increased bedside PICC placement and employed a patient-centered and timely process.” (Conlin, et.al., 2019)
How Can My Facility Implement A PICC Team?
When it comes to PICC insertion, many facilities have long ago recognized the benefits of utilizing a specialized PICC team comprised of certified RNs. Other facilities, such as rural and critical access hospitals are faced with the barriers of training and implementing PICC teams, which can be costly, time consuming and out of reach considering today’s challenges in health care delivery.
This is where Vascular Access Plus comes in. As an independently owned and managed vascular access team, comprised of highly trained RNs, we can help fill in the gaps between vascular access needs and services. We provide PICC, midline and difficult PIV services across Nebraska, Iowa, South Dakota and Kansas.
Our RNs undergo extensive training and annual competency evaluation to ensure we are able to provide safe, efficient and cost effective services. Whether in a small critical access hospital or in a large trauma center, our patient centered beside PICC services can help you improve outcomes, which can ultimately reduce costs and improve quality scores.
We are also happy to help you design, implement and train a vascular access team within your own facility, to achieve the goal of meeting the individualized needs of your patients, providers and community.
To learn more about how RN PICC placement at the bedside may benefit your patients, or just to learn more about what we do contact us at vascularinfo@vascularaccessplus.com.