Failure to Perform Timely PICC Line Dressing Changes per Standards of Practice
Penalty
Summary
The deficiency involves the facility’s failure to ensure safe and appropriate administration of IV therapy by not performing Peripherally Inserted Central Catheter (PICC) dressing changes according to professional standards for one resident. During observation, the resident was noted to have a PICC line in the right upper arm with a transparent dressing dated 2/11, indicating it had not been changed weekly as required. An LPN stated that PICC dressings are supposed to be changed weekly, believed to be on Saturdays, and another LPN reported that the RN supervisor typically changes all PICC dressings but was not present that day. The Director of Nursing confirmed that PICC dressings should be changed every week and that it is the responsibility of the nurse on the cart, acknowledging that this resident’s dressing should have been changed and that there was no physician order for PICC dressing changes. Review of the facility’s skin and wound management policy showed that wound care is to be managed based on current standards of practice, with a physician order documented on the Treatment Administration Record when skin impairment is identified, but no such order existed for this resident’s PICC dressing care. These findings demonstrate that the facility did not follow its own policy and professional standards regarding PICC line dressing changes and lacked appropriate physician orders for this aspect of the resident’s IV therapy care.
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