Improved Levels of Patient Care in the United Kingdom as Nurses Gain Experience with PICCs

Abstract

P eripherally inserted central catheters (PlCCs) are a group of single, dual and triple lumen central venous access devices that can range in gauge size from 3Fr to ?Fr. Currently only the single and dual lumen PICCs are available in the United Kingdom (UK). Venous access is achieved by accessing either the cephalic, basilic or median cubital veins in the patient's arm. The PICC is then advanoed through the cannula/introducer until its tip reaches the superior vena cava. Confirmation of the tip location is achieved by undertaking a chest X-ray, or by fluoroscopy.' Although widely used in the United States of America (USA) since the late 1970s. PICCs were not introduced into clinical practice in the UK until 1994.' In 1995, the UK Department of Health (DoH) published a document entitled "A Policy Framework for Commissioning Cancer SeIvices," commonly referred to as 'The Calman-Hine Report." This report set out the strategy for ensuring that individuals being treated for a malignant condition throughout England and Wales receive a uniformly high standard of care. As a result, care for an individual patient would no longer be dependent upon where they lived and would also address their individual needs. 1n 2000, "The NHS Cane",r Plan" was published' This document identified the Government's objectives for improving the provision of cancer setvices, and went on to recommend that care should be evidence-based, together with making more effective use of the skills held by the existing workforce. As nurses in the UK have learned more about and become more experienced with the use of PICCs there has been an improvement in patient care.