Comprehensive Nursing Pharmacology Q 279
A male patient needs a percutaneously inserted central catheter (PICC) for prolonged IV therapy. He knows it can be inserted without going to the operating room. He mentions that, “at least the doctor won’t be wearing surgical garb, will he?” How will the nurse answer the patient?
A. “You are correct. It is a minor procedure performed on the unit and does not necessitate surgical attire.”
B. “To decrease the risk of infection, the doctor inserting the PICC will wear a cap, mask, and sterile gown and gloves.”
C. “It depends on the doctor’s preference.”
D. “Most doctors only wear sterile gloves, not a cap, mask, or sterile gown.”
Correct Answer: B. “To decrease the risk of infection, the doctor inserting the PICC will wear a cap, mask, and sterile gown and gloves.”
Strict aseptic technique including the use of a cap, mask, and sterile gown, and gloves is required when placing a central venous line including a PICC. Options A, C, and D are incorrect statements. They increase the risk of infection. Central line-associated bloodstream infection (CLABSI) continues to be one of the most deadly and costly hospital-associated infections.
Option A: Personal protective equipment should be worn. Insertion is performed using the maximal sterile barrier technique.
Option C: All personnel involved must perform hand hygiene before donning and after doffing PPE (e.g. gloves). A 2% chlorhexidine-based antiseptic must be used for skin preparation. Povidone-iodine may be used if a patient is allergic to chlorhexidine.
Option D: Personal Protective Equipment (PPE) to be worn include sterile gown and gloves as well as a mask with attached visor & cap to be worn by all personnel directly involved in the insertion procedure. Circulating staff need to wear a cap and mask with attached visor within 2 meters of the sterile field. The patient is to be covered with a full-body sterile drape.