Step 9 - Explain the procedure to the patient
|
Previously orient patients on the importance of being informed about their treatment in order to improve quality and safety of the procedure |
No explanation or poor explanation |
Uninformed patient who can’t provide alerts and feedback |
1 |
3 |
3 |
Unaltered |
Step 10 - Prepare the environment for the procedure
|
Periodic training on the maintenance of PICC patency with saline solution and/or saline-filled syringe |
Patient in inadequate position, poor lighting, absence of containers for material disposal |
Delay in the procedure, inappropriate waste disposal |
3 |
1 |
3 |
Unaltered |
Steps 11 and 17 - Perform hand hygiene with alcohol gel and put on gloves
|
Periodic awareness-raising activities and training on hand hygiene and correct use of gloves |
Inadequate hygiene, inappropriate use of gloves |
Cross contamination |
3 |
1 |
3 |
Unaltered |
Step 12 - Clean the catheter connector with a swab with alcohol for 5 to 15 seconds and discard swab in trash
|
Periodic training on the prevention of bloodstream infection; double-checking actions involving the patient |
Absent or insufficient disinfection |
PICC contamination, bloodstream infection, increased length of hospital stay |
3 |
3 |
9 |
Unaltered |
Step 13 - Attach syringe to catheter and check for resistance to infusion
|
Periodic training on the maintenance of PICC patency with saline solution and/or saline-filled syringe; double-checking actions; notification of cases of abnormal resistance to the PICC team |
No verification or wrong verification, step not performed as recommended |
PICC occlusion, rupture of catheter tip, embolism, increased length of hospital stay, risk of death |
4 |
2 |
8 |
Unaltered |
Step 14 - Flush catheter with saline solution
|
Exclusive use of the saline-filled syringe; periodic training on the maintenance of PICC patency |
Use of syringe with wrong thickness and/or inadequate infusion of volume of saline solution |
PICC occlusion, rupture of catheter tip, embolism, increased length of hospital stay, re-examination, new catheterism required |
4 |
1 |
4 |
1 |
1 |
1 |
Step 15 - Repeat steps 13 and 14 of the procedure with the other syringes
|
Exclusive use of the saline-filled syringe; periodic training on the maintenance of PICC patency |
Contamination of syringe, use of syringe with wrong thickness and/or inadequate infusion of volume of saline solution |
PICC occlusion, rupture of catheter tip, embolismn increased length of hospital stay, risk of death, infection |
4 |
2 |
8 |
4 |
1 |
4 |
Step 16 - Discard materials
|
Periodic awareness-raising activities and training on appropriate waste disposal |
Materials discarded in inappropriate places/containers |
Cross contamination |
3 |
1 |
3 |
Unaltered |