Patient Education


The patient or caregiver can be taught the procedure for maintaining the PICC line. The following is a sample care plan and visit schedule for home care of a patient with a PICC line. The visit frequencies were determined by a random, informal survey of home health care nurses who use PICC lines in their practice. The frequencies may need to be altered based upon the needs of the patient and caregiver.

Sample Home Health Care Plan for PICC Care (without home infusion)

Visit # Assessment Intervention Evaluation

Visit 1

Frequency 3 visits/wk

Full admission assessment if not previously completed.

Assess insertion site, note any leakage from catheter or around the site. Note any redness, drainage or pain at the site.

Document condition of site and dressing.

Demonstrate dressing change to patient.

Demonstrate proper flushing technique and cap change.

Teach patient frequency of dressing change, cap change and flushing.

Teach patient and/or caregiver principles of PICC dressing change.

Teach patient/caregiver signs of catheter leakage, infection at site.

Teach patient and /or caregiver warning signs of catheter problems and when to call the home health nurse or physician's office.

Provide patient and /or caregiver with written material for a reference.

Patient will verbally demonstrate understanding of the teaching.
Visit 2 Assess PICC line site, line note any leakage from catheter or around the site. Note any redness, drainage or pain at the site.

Document condition of site and dressing.

Assess patient's retention of previous teaching.

Reinforce prior teaching. If PICC dressing needs to be changed at this time. Allow patient to return demonstrate if patient is comfortable with this. If not, demonstrate dressing change and routine line care. Patient will demonstrate proper dressing change and cap change. Patient will demonstrate proper flushing techniques

Or

Patient will verbally demonstrate understanding of teaching.

Visit 3 Assess PICC line site, line note any leakage from catheter or around the site. Note any redness, drainage or pain at the site.

Document condition of site and dressing.

Assess patient's retention of previous teaching.

Verbally repeat steps of PICC dressing change, cap placement and flushing .

Allow patient and /or caregiver to demonstrate the above.

Patient will accurately demonstrate PICC dressing change, cap change and flushing.

Patient will verbally demonstrate understanding of procedures to follow if a PICC line problem occurs.

Patient will verbally demonstrate understanding of criteria for calling home health nurse or physician for problems.

Week 2

Visit 4

Discharge if appropriate.

Assess PICC line site, line note any leakage from catheter or around the site. Note any redness, drainage or pain at the site.

Document condition of site and dressing.

Assess patient's retention of previous teaching.

Assess patient's ability to perform PICC care

Allow patient and /or caregiver to demonstrate PICC care, cap change and dressing change.

Provide patient with additional written materials pertaining to PICC care.

Patient will accurately demonstrate PICC dressing change, cap change and flushing.

Patient will verbally demonstrate understanding of procedures to follow if a PICC line problem occurs.

Patient will verbally demonstrate understanding of criteria for calling home health nurse or physician for problems.


Instant Feedback:   Please visit the CDC resource again, and look under "Strategies for Prevention of Catheter-Related Infections in Adult and Pediatric Patients" (Quality Assurance and Continuing Education paragraph) and be prepared to answer the following question.

 

Which choice is not associated with reducing catheter related infections.
strict adherence to aseptic technique
specialized "IV teams"
adequate staffing
staff inexpereienced in catheter care

Instant Feedback:

Demonstration of PICC line care and a discussion of aseptic principles should precede a patient return demonstration of PICC care.
True
False


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