Removal of Non-Tunneled Central CathetersSMH IP 2033

By Brenda J. John, MSN, MS-HSA, RNNurse Manager, IVR/Cath Lab/EP/Device

Objectives

The learner will be able to state the new process for the safe removal of non-tunneled central catheters at SMH.

Type of Roll-out: (select one )

Process change

This Roll-out Applies to the Following:

Inpatient areas Outpatient areas Nurses

Removal of Non-Tunneled Central Catheters - SMH IP 2033

Before Catheter is Removed…

A documented Physician’s Order must be verified in the medical record requesting removal of the line

The lines may be removed by: a house intensivist, surgeon, nephrologists, or a nurse that has demonstrated competency in removing central lines.

*Note: A physician or radiologist must always perform the removal of a Cuffed Tunneled Catheter.

Removal of Non-Tunneled Central Catheters - SMH IP 2033Identifying Non-Tunneled V. Tunneled Catheters Non-tunneled Catheters: external catheters that

extend beyond the skin directly from point of venous access.

Tunneled Catheters: Can be Palpated beneath the skin and tracked to point of venous access. May or may not have external catheter(i.e.Port)

Removal of Non-Tunneled Central Catheters - SMH IP 2033

Common NON-TUNNELED Catheters at SMH:

Temporary Dialysis Catheter (a.k.a. Trialysis Catheter)

Peripherally InsertedCentral Catheter

Central Venous Catheter

Removal of Non-Tunneled Central Catheters - SMH IP 2033

Common TUNNELED Catheters at SMH: (REMOVED BY MD ONLY!!)

Tunneled Dialysis Catheter

Port-A-Cath

Tunneled Hickman Catheter

Removal of Non-Tunneled Central Catheters - SMH IP 2033

Temporary Dialysis Catheters (a.k.a Trialysis Catheters)

Call IVR to the have PICC Nurse remove the catheter, Monday through Friday, 8am to 3pm

After 3pm, Holidays, and Weekends, call the House Nursing Supervisor to remove the catheter

Removal of Non-Tunneled Central Catheters - SMH IP 2033

Peripherally Inserted Central Catheters (PICC Lines)

&

Central Venous Catheters (CVC Lines) Line removal procedure per Mosby’s Nursing Skills: “Central

Venous Catheter: Removal” All units are responsible for the removal of their floor’s lines Floors are to ensure adequate coverage during day and night

shifts, weekends, and holidays COMPETENCY of RNs will be ensured by the respective

department’s Clinician Department Leaders to also receive training for unit coverage

Summary Obtain Physician Order for Line Removal Verify Line is NON-TUNNELED Catheter Temporary Dialysis Catheter Removal◦ Mon-Fri 8am to 3pm – by PICC RN Contact IVR @ 28045

◦ After 3pm, Holidays, & Weekends – by House Supervisor Contact House RN Supervisor @ 76294

PICC & CVC Removal◦ 24/7 coverage by Competent department RN Line removal procedure per Mosby’s Nursing Skills: “Central

Venous Catheter: Removal”

Resources

SMH IP 2033

Mosby’s Nursing Skills: Central Venous Catheter: Removal

References

Kalender, N., & Tosun, N. (2015). Nursing Studies about Central Venous Catheter Care: A Literature Review and Recommendations for Clinical Practice. International Journal Of Caring Sciences, 8(2), 461-477 17p.

Khan, H., & Zaidi, A. (2013). Paradoxical air embolism following central venous catheter removal. BMJ Case Reports, 1-3 3p. doi:10.1136/bcr-2013-200630

has successfully completed the Roll-out computer based training for

This Certificate Certifies That

“Removal of Non-Tunneled Central Catheters”

July 2016