I have done a great deal of research on this subject and from all the
information that I have gathered, it is preferred that the RN does NOT
remove the epicardial wires. There is a mixed opinion on the mediastinal
tubes from the sources that I have reviewed. We have CVsurgeons that
have midlevels working for their practice, NP or PAs, and they are doing
this under the approval and auspices of the surgeons. With this being
said, we have chosen at our facility to change our practice and NOT have
our CV nursing staff assume the responsiblity of potential complications
with the removal of these devices. It did take some adjustments for this
to change, but from a liability standpoint, we chose to change our
practice patterns and policy and take this out of the nursing realm of
responsibility.

We just had our JCAHO survey and I wish you good luck with yours.

Kimberlee Melton, RN BSN CCRN
Manager of Critical Care Education and Quality




"Carol Meeks" <ckmeeks@...>
Sent by: nursebob@yahoogroups.com
11/05/2005 07:04 AM
Please respond to
nursebob@yahoogroups.com


To
<nursebob@yahoogroups.com>
cc

Subject
Post cardiac surgery chest tube and epicardial pacing wire removal by ICU
RN






First, let me thank you for your web site. I have a shortcut to it on all
my computers in the CVICU at our facility because the information is so
useful and expansive. I am the Manager and am always looking for resources
for my nurses. You are top notch!

My question and request:
I am researching RN removal of CVTs and epicardial pacing wires for policy
writing. My approved nurses have been doing it since 2000 but we never had
a policy until now. Florida BON replies they have not issued nor plan to
issue a declaration of policy on the subject so I am reviewing all state
NPAs to establish what other states are doing. What is your experience
with this, as I am sure your group has expansive research databases? Your
reply is awaited as we have Joint Commission Nov 14th and I must have a
policy in place.

Sincerely,
Carol Meeks RN CCRN
Manager CVICU
Bay Medical Heart Institute
Panama City, Fl

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