PICC PICC Equipment & Device Selection 2 — Questions and Answers
Question 1: Per INS standards, what is the preferred method for PICC external securement?
- Sutures at the insertion site
- Sterile surgical tape
- Engineered stabilization device (ESD) (Correct answer)
- Cloth tape over the hub
Correct answer: Engineered stabilization device (ESD)
INS guidelines recommend engineered stabilization devices (ESDs) as first choice because they reduce migration, dislodgement, and infection risk compared to sutures or tape.
Question 2: How often should a transparent semipermeable membrane (TSM) dressing on a PICC site be routinely changed?
- Every 24 hours
- Every 48 hours
- Every 5–7 days or when soiled, loose, or no longer intact (Correct answer)
- Every 2 weeks
Correct answer: Every 5–7 days or when soiled, loose, or no longer intact
TSM dressings should be changed every 5–7 days or immediately if compromised, per CDC and INS guidelines, to maintain site integrity and reduce infection.
Question 3: A chlorhexidine-impregnated dressing is MOST indicated for which PICC patient?
- All PICC patients regardless of risk
- When a standard TSM dressing is temporarily unavailable
- A patient at elevated CRBSI risk when standard bundle measures have not sufficiently reduced infection rates (Correct answer)
- Pediatric patients only
Correct answer: A patient at elevated CRBSI risk when standard bundle measures have not sufficiently reduced infection rates
Chlorhexidine-impregnated dressings are recommended as an additional intervention for high-risk patients when basic CRBSI prevention bundles alone have not achieved adequate infection control.
Question 4: What is the primary mechanical purpose of an external PICC securement device?
- Prevent air embolism at the insertion site
- Prevent catheter migration and accidental dislodgement (Correct answer)
- Facilitate easier medication administration
- Reduce catheter-related bloodstream infections directly
Correct answer: Prevent catheter migration and accidental dislodgement
Securement devices anchor the catheter to minimize migration and accidental pull-out, which can cause malposition, extravasation, or dislodgement.
Question 5: Which type of needleless connector was associated with higher CRBSI rates due to complex internal fluid pathways and is no longer recommended?
- Neutral displacement connector
- Positive displacement connector
- Original negative displacement mechanical valve connector (Correct answer)
- Antimicrobial needleless connector
Correct answer: Original negative displacement mechanical valve connector
Original negative displacement mechanical valve connectors created internal dead space that harbored organisms, leading to higher CRBSI rates and subsequent replacement with improved designs.
Question 6: An alcohol-impregnated antiseptic hub cap (passive disinfection cap) on a PICC needleless connector primarily functions to:
- Replace hand hygiene before line access
- Passively disinfect the connector between accesses without additional scrubbing (Correct answer)
- Sterilize medication before injection into the line
- Replace active scrub technique when the cap is applied
Correct answer: Passively disinfect the connector between accesses without additional scrubbing
Passive disinfection caps continuously deliver antiseptic to the connector surface between accesses, reducing microbial contamination without replacing active hand hygiene or scrub technique.
Question 7: What is the minimum recommended saline flush volume for a PICC after each use per INS guidelines?
- 1 mL
- 5 mL
- 10 mL (Correct answer)
- 20 mL
Correct answer: 10 mL
A minimum of 10 mL of normal saline is recommended to flush PICCs after each use to clear the long lumen of blood and medication residue.
PICC PICC Equipment & Device Selection 2
Per INS standards, what is the preferred method for PICC external securement?