On-Call Expertise Prevents Unnecessary PICC Removal highlights a case where Vascular Wellness properly placed an ECG Tip confirmed PICC that the hospital mistakenly believed needed removal due to an X-ray reading. A Vascular Wellness on-call advanced clinician was immediately connected with the facility and helped guide them through a quick and successful, evidence-based resolution resulting in the much-needed PICC remaining in this DIVA patient for continued therapy.
On-Call Expertise Prevents Unnecessary PICC Removal
– Clinical Case
A patient in a hospital with hidradenitis suppurativa, a condition also known as acne inversa that causes small painful lumps to form under the skin, needed a PICC line. This patient had extensive and large amounts of scar tissue in and around the axilla on both upper extremities from previous surgical excisions, making vascular access difficult to achieve.
The facility contacted Vascular Wellness to place a PICC line, and a vascular access clinician arrived a short while later. Upon arrival, the nurse clinician began a detailed patient assessment and noted that both the patient and her spouse were very anxious about the procedure.
On-Call Expertise Prevents Unnecessary PICC Removal
– Diagnosis and Treatment
Knowing that both the patient and her spouse were particularly nervous, the Vascular Wellness nurse clinician paused his preparations to spend extra time helping them feel comfortable and knowledgeable before proceeding. As the vascular access clinician began placing the PICC line, the patient’s husband fainted, and the clinician was able to call for help to take care of the spouse and complete the patient procedure without any complication or difficulty. Proper placement was confirmed via ECG tip confirmation technology, and the PICC line was able to be used right away. The patient care team was delighted as they were very concerned about the ability to obtain vascular access at the bedside for this DIVA patient, which if not obtained, would have caused lengthy delays in treatment as well as complex and costly transportation.
Early that evening, the facility contacted the Vascular Wellness Vascular Support Team (VST), which is the 24/7 support team for clients. The VST was informed that it was hospital policy that line placements are confirmed via X-ray, even if proper placement of a vascular access device is confirmed via ECG tip confirmation technology, and that they believed the X-ray showed placement of the device over the coracoid process (an osseous curved structure off the scapula that projects forward). Based on their reading of the X-ray, the ordering physician was requesting that Vascular Wellness remove the PICC line immediately.
Vascular Wellness maintains an advanced vascular access clinician on-call and available 24/7 to clients via the VST for questions, consults, and troubleshooting, so the VST representative requested that the facility hold the removal order so they could contact the on-call clinician to assist. The on-call clinician reviewed the case and patient record, and then based on the findings, recommended retaking the X-ray with a RPO (right posterior oblique) view to obtain a better image of the area in question. The facility agreed and while this was being done, the vascular access clinician who placed the line remained on standby in case he needed to return to the facility.
A short while later, the facility reported that the X-ray showed perfect placement of the PICC line, and expressed tremendous gratitude for the guidance, expertise, and patience of Vascular Wellness and the clinicians – all at no extra charge to the facility. The patient and her spouse, nurse, and medical team were so thankful that the PICC was not pulled, especially since the patient’s excessive scarring made vascular access a challenge.
Vascular Access Specialists
– Key Points
This clinical case, once again, demonstrates why using Vascular Access Experts who focus on quality, safety, consistency, reliability, and timely response improves patient outcomes and reduces costs.
Unlike other PICC mobile companies, Vascular Wellness is a complete solution and not a transactional one. The team is trained to treat every case as if the patient is their mother, meaning we invest the time to understand the patient and medical history, the use of the line, and the intended therapy to help ensure the right line is placed. Our 24/7 call center is highly trained to understand vascular access and help triage cases, including sending them to our Vascular Access Nurse Clinician Administrator on Call, who then has an additional team of advanced clinicians if further review is warranted. Our clients love the full lifecycle of support that our team provides.
While a transaction PICC, Midline, or PIV may seem to be the most inexpensive solution, all it takes is one patient case to make that “cheap” solution become the most expensive one, and in a significant manner. It’s not hard to see how complex and costly transportation, additional therapy days, incremental medical care and resources, and brand and reputation damage can add up fast. And from our experience in helping solve other nursing companies’ mistakes, this happens frequently.
Teaming with Vascular Wellness means clients can rely on a dedicated professional team of both (1) Vascular Access Board Certified (VA-BC), insured, and skill-verified Vascular Access Experts, and (2) administrative and support specialists, all working to ensure the best, short- and long-term solution for all their bedside vascular access needs. With Vascular Wellness, clients know that they get the benefit of the most innovative and up-to-date procedures and best practices that are unmatched in the industry. Vascular Wellness is the smart and safe choice for Vascular Access for all healthcare settings.
Nurse Clinicians in Action is a spotlight series highlighting some of the interesting cases that Vascular Wellness clinicians have encountered and participated in treatment. These cases involve challenging situations or intriguing clinical presentations and may involve more than one Vascular Wellness clinician, as our clinicians have the ability to consult each other while in the field, as well as an on-call Clinical Administrator via a HIPAA (Health Insurance Portability and Accountability) compliant communication app. In addition, our extensive training program and diverse client base, including Level 1 Trauma Centers, Short Term Acute Care Hospitals, Long Term Acute Care Hospitals, and Skilled Nursing Facilities, provide our clinicians with a wide array of clinical experience and why we believe our clinicians, as a group, are the most experienced and best trained and supported vascular access clinicians.
If you require Vascular Access or want to learn more, speak to the team at Vascular Wellness today.
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Vascular Wellness provides:
(1) Comprehensive vascular access services to North Carolina, Oklahoma, South Carolina, and Virginia; and
(2) Customized vascular access services to Arkansas, Delaware, Georgia, Mississippi, Pennsylvania, Tennessee, and West Virginia; and
(3) Support vascular access services to Ohio and Kentucky.
Read more NCIA Patient Cases
Nurse Clinicians in Action stories highlight some of the interesting cases in which Vascular Wellness clinicians have encountered and participated as valuable team members.
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