Remove PICC, Place New PICC: Recommendation
Many thanks to dc for the following question submitted on 3/24/2014:
Q. Patient has a PICC line, develops a CLABSI, Line to be discontinued, and ID orders new PICC placed. What is the current school of thought? If the patient has peripheral access, is it still considered preferable to wait 48 hours prior to placing new PICC line if possible? If so, is there any supporting literature to back this?
A. Current thought is: no wait necessary. The only reason a process to drag ones feet was recommended was to get the results back from blood cultures and avoid a possible second removal. These days cultures are rarely being drawn (for good reason) and so no wait is necessary IF the patient still needs access (of course, they have an infection). There is no literature to back this up because there was no literature in the first place promoting a delay. If a patient needs access and a PICC is considered the most appropriate, then a second PICC is warranted if the first one is compromised. (Reply from Nancy Moureau, BSN, RN, CRNI, CPUI, VA-BC on 3/24/2014)