1. SRT PICC
HOW WE DO IT

2. References
INFUSION NURSES SOCIETY
• 2011 Infusion Nursing Standards of Practice

3. References
CENTRE FOR DISEASE CONTROL
Guidelines for the Prevention of Intravascular
Catheter-Related
Infections, 2011

4. MEMORY AID
• Wash Your Hands First
• Use Body Fluid Precautions
• Aseptic Care Of The Vascular Access Devices
• The Fluid Pathway Must Remain Sterile
• All Cleaning Solutions Must Be Allowed To Dry
• Catheters Must Be Secured
• Do Not Remove A PICC

5. WHAT IS A PICC

6. WHAT IS A PICC

7. WHAT IS A PICC

8. WHAT IS A PICC

9. WHAT IS A PICC

10. WHAT IS A PICC

11. ASEPSIS
• Medical Asepsis
– clean: reduce and prevent spread of
microorganisms
– sterile: aim to eliminate microorganisms
• Surgical Asepsis

12. FLUSH THE CATHETER
• ASSESS CATHETER PATENCY
• BLOOD RETURN
• FLUSHES FREELY

13. FLUSH THE PICC
1. Wash your hands first.
2. Use body fluid precautions.
3. Aseptic care of vascular access devices.
4.The fluid pathway must remain sterile.
5. All cleaning solutions must be allowed to dry
completely.
6. Catheters must be secured.
7. Do NOT remove a PICC.

14. FLUSH THE CATHETER
• FIBRIN SHEATH

15. FLUSH THE CATHETER

16. FLUSH THE CATHETER

17. MALPOSITION

18. MALPOSITION

19. FLUSH THE PICC
• The Infusion Nursing Standards of Practice establishes
the national standard for all infusion therapy.
• This standard on flushing emphasizes the goals of
maintaining patency and preventing contact between
heparin and incompatible solutions.
• The standard incorporates the concepts of catheter
flushing and locking. Flushing assesses catheter
patency and functionality and removes the previously
infused medication. Locking the catheter creates a
closed column of fluid inside the catheter lumen
intended to prevent blood from moving into the
lumen. (IV)

20. FLUSH THE PICC
• SASH Saline Admixture Saline Heparin
• Lock non-valved catheters with positive
pressure.

21. FLUSH THE PICC
• Vascular access devices shall be flushed prior to each
infusion as part of the steps to assess catheter function
• Vascular access devices shall be flushed after each
infusion to clear the infused medication from the
catheter lumen, preventing contact between
incompatible medications.
• Vascular access devices shall be locked after
completion of the final flush solution to decrease the
risk of occlusion. (IV)
• SASH Saline Admixture Saline Heparin

22. PICC SKIN CLEANING SOLUTIONS
• >.5% Chlorhexidine
• Povidone-iodine
• 70% Alcohol

23. DRESS THE PICC
• Wash Your Hands First
• Use Body Fluid Precautions
• Aseptic Care Of The Vascular Access Devices
• The Fluid Pathway Must Remain Sterile
• All Cleaning Solutions Must Be Allowed To Dry
• Catheters Must Be Secured
• Do Not Remove A PICC

24. DRESS THE PICC
• Replace transparent dressings used on
tunneled or implanted CVC sites no more than
once per week (unless the dressing is soiled or
loose), until the insertion site has healed.
• Replace catheter site dressing if the dressing
becomes damp, loosened, or visibly soiled
• Replace dressings used on short-term CVC
sites every 2 days for gauze dressings. (CDC)

25. DRESS THE PICC
• Remove the old dressing in the direction of
the insertion site to avoid pulling out the
catheter.
• Secure the catheter.
• Work from clean to dirty.
• Clean everything that will be under the new
dressing, skin and catheter

26. DRESS THE PICC

27. DRESS THE PICC
1. Wash your hands first.
2. Use body fluid precautions.
3. Aseptic care of vascular access devices.
4. The fluid pathway must remain sterile.
5. All cleaning solutions must be allowed to dry
completely.
6. Catheters must be secured.
7. Do NOT remove a PICC.

28. SECURE THE PICC
• Use a suture less securement device to reduce
the risk of infection for intravascular catheters
[105]. Category II

29. DO NOT REMOVE THE PICC
1. Air Embolism
2. Syncope
3. Venous Spasm
4. Catheter Fracture

30. VENOUS SPASM