Peripherally Inserted Central Catheter (PICC) Post Insertion Orders

Document Sample
Peripherally Inserted Central Catheter (PICC) Post Insertion Orders Powered By Docstoc
					                                                                                              PLACE LABEL HERE
PERIPHERALLY INSERTED CENTRAL CATHETER (PICC)
POST INSERTION
ORDERS
    The following orders will be implemented. Orders with a “” are choices and are NOT implemented unless checked.
         Initial all handwritten order modifications and the bottom of each page when indicated (multipage).

1. Diagnosis      Same as preprocedure plan __________ (initials)
   and            Admit as Inpatient ________________________________________(reason for admission)
   Status:        Place in Observation _____________________________________(reason for observation)

2. Unit:         ICU  IMCU/PCU  Telemetry Floor  Any Floor Telemetry  Any Floor (No Telemetry)
3. Line placement verified and PICC ready to use

4. Flush PICC with normal saline 10 ml after intermittent medication administration

5. Flush PICC with normal saline 20 ml after administering viscous fluids or blood sampling

6. Flush PICC with normal saline 10 ml q shift when not in use

7. Leave unclamped when CLC 2000 is in place

8. All flushing and IV bolus medications must be done with 12 ml or larger syringe

9. Change dressing, catheter securement device, and positive pressure cap q 7 days and prn

10. No blood pressure readings, tourniquet use, blood draws or IV sticks to arm with PICC

11. Notify patient’s attending physician if signs of infection, vascular compromise, swelling, or any resistance
    during injection develop

12. Contact the ordering physician to resume anticoagulants

ADDITIONAL ORDERS:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________

______________          ___________________             _________________________________             __________
Date                    Time                            Physician Signature                           PID Number



Send copy to pharmacy


*1-16755*                         FORM 1-16755 REV. 07/2012                                                 Page 1 of
1

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:25
posted:10/1/2012
language:Unknown
pages:1