Categories

PICC Certification: What Does It Mean?

I am starting off our blog with this topic because we often get the question- After I take a class, am I then PICC certified? or What is involved in becoming PICC certified? I have always tried to be careful to not loosely use the words “PICC certification” and instead used words to describe meeting competency criteria for independence in PICC insertion and care. The problem primarily is with the use of the word “certification”. On their website the American Board of Nursing Specialties (ABNS) defines certification as “the formal recognition of the specialized knowledge, skills, and experience demonstrated by the achievement of standards identified by a nursing specialty to promote optimal health outcomes”. Nurses that insert and care for PICC line catheters as a primary part of their job may opt to specialize in infusion nursing, but the performance of PICC insertion and care procedures does not qualify as a separate nursing specialty. In spite of this fact, establishing and obtaining competence in PICC insertions is commonly referred to within health care as obtaining “PICC Certification” or becoming “PICC certified”. Therefore many clinicians looking to obtain training in PICC insertion and care procedures often search for PICC certification programs. The words “PICC certification” do not have a standard definition; i.e. there is no non-profit third party organization that is dedicated to defining and establishing standards for PICC certification. In health care, there are other skills that have non-profit organizations that establish the criteria for certification. CPR certification overseen by either the American Heart Association or the Red Cross is an example of this. But since there is no organization like this in existence for PICC certification, the establishment of criteria for credentialing clinicians in PICC certification is done by organizations involved in training clinicians in PICC care and insertion procedures. This includes health-care facilities and continuing education companies. Program content and requirements can vary widely.

With such a wide variety of programs available, how do you choose a PICC education program to best suit your needs? Fortunately, state guidelines and organizations such as the Infusion Nurses Society (INS) exist. The INS is a non-profit organization established in 1973 to ensure high quality in infusion therapy for patients and to establish standards and guidelines to be followed by nurses involved in the specialty practice of infusion therapy care and procedures. The INS has published standards of practice position papers that require clinicians to possess and demonstrate specific and comprehensive knowledge related to PICC insertion and care. Another important organization is the Association of Vascular Access (AVA), AVA is a multidisciplinary organization composed of clinicians, educators, regulators and manufacturers from the medical field of Vascular Access. Part of AVA’s published mission is to improve patient safety, comfort and outcomes; and optimize professionals’ knowledge and skills in vascular access. The best programs will have their education and clinical assessment criteria founded on the basis of standards, guidelines, and recommendations set by government and leading industry organizations such as the INS and AVA and organizations like the Center for Disease Control (CDC), the Joint Commission (JCHAO), and the Institute for Healthcare Improvement (IHI).

Unfortunately, the expectation that one can be certified in PICC insertion simply by taking a one day class is encouraged by companies that advertise certification granted solely after taking their one day, 8 hour or so PICC training class. Is that true, and possible? Not likely. The more likely scenario is that the ad leaves out the clinical precepting requirement. Or it is possible that the ad is correct and all that is required for PICC “certification” by such a company is an 8 hour class room only experience with maybe a few insertions on class mates. I have to ask myself would I want a clinician finishing such a program inserting a PICC line in me or one of my family members? My answer?… Uhm, no.

A reputable company that provides continuing education in infusion related procedures stays current with industry practices and established guidelines and passes on applicable information to their trainees. The INS has published a position paper on PICCs in which the qualifications for insertion section states that the INS supports that a licensed physician or registered nurse that is educated and has demonstrated competency can insert a PICC. Regarding RNs, the position paper goes on to state: “The RN must have demonstrated competency and proficiency in intravenous therapy, including the insertion of short peripheral catheters, and a solid understanding of central venous catheters. Additionally, the RN should complete an educational program for PICC insertion. The education program must include both theoretical content and clinical instruction on an anatomical model. Once the nurse has validated initial competency, there must be an ongoing continuum of competency. An organization or facility must establish a program for maintaining clinical competency for device insertion within its chosen framework. Ongoing competency validation includes the knowledge and ability to perform the insertion safely and knowledge of appropriate care and maintenance strategies. All facilities involved with insertion of PICCs should have formal organizational policies and procedures in place that provide clear lines of responsibility for insertion, care, and maintenance. Finally, qualifications for inserting PICC lines must be consistent with state and federal laws.” Potential trainees should be aware of the PICC line procedure criteria that govern their practice in their state of residence. For example in Connecticut (our state of primary operations); the Board of Examiners for Nursing has published specific guidelines that spell out requirements for registered nurses inserting and removing specialty lines like PICC line catheters. These guidelines are very similar to the INS PICC position paper regarding qualifications for insertion and in addition the Connecticut guidelines include a requirement that a nurse must possess “substantial knowledge and experience in intravenous therapy” (click here to view a copy of these guidelines). To meet established industry criteria for PICC insertion and care the completion of a period of supervised clinical experience following a PICC insertion education class is a necessity. In addition to the technical skills, PICC insertion and care requires patient assessment and critical thinking skills that include the ability to judge when to change course in the procedure.

How do clinicians obtain PICC certification after completion of a PICC Resource class? There are two ways to complete training and become certified after a class, the traditional way through the clinician’s employing facility, or through a private PICC education company like ours. The traditional option is the way most clinicians have completed their training and become independent in PICC insertion and care procedures. This involves becoming credentialed by the employing facility after meeting their established policy and competency requirements that includes completion of a supervised clinical component. After our PICC insertion education programs; a client may use our tools to document meeting competency requirements. Whichever method is used; documentation and clinical supervision of the initial insertions and independence in the procedure is required. Does certifying either of these ways confer a national certification? Individual facility conferred certification is considered an “in-house” type certification that may not be recognized if a clinician leaves to practice at an outside facility. In actual practice if the PICC education program completed was administered by a national company and the clinician can produce proof of competency with an accepted number of supervised and independent clinical insertions; it is likely that the new facility will accept the certification. Regarding PICC Resource Associates, LLC programs– we are a national organization in that we offer continuing education programs that are accepted throughout the U.S. Our program contact hours are offered through an American Nurses Credentialing Center (ANCC) approver and they are valid nationally.

November 1st 2010: I have updated this post. The previously mentioned Asssociation for Vascular Access (AVA) has started the Vascular Access Credentialing Corporation (VACC), and they now offer a certification in Vascular Access. See my reply dated 10/31/2010 to a question on the original post for details.

21 comments to PICC Certification: What Does It Mean?

  • Hi Emily, I will email you privately today. Alice

  • emily

    Hi! I currently live in northeastern Kentucky and hold licensure in both KY and OH. I am interested in learning PICC insertion/maintenance/care. what I can not find is how to go about this in my area. Please help me.

  • Hi Phllip, My advice is go for it! Obtaining the VA-BC (Vascular Access-Board Certified) is well worth it. The formation of the VACC as the certification arm of AVA, was long awaited by those of us in vascular access familar with the high quality of programs and leadership that is offered by AVA.
    Good luck.

  • Phillip Lindesmith

    Hi Alice,
    What in your opinion, are the advantages of becoming VACC certified? The certification is pretty expensive ($300-$400) and I want to know I’m not just buying a bunch of letters to put behind my name. I am and experienced PICC nurse and also work in the cath lab.
    Thanks

  • Hello, First my apologies for being away from the blog for so long- my hiatus of sorts. I have some help and I am back to do regular updates and additions to the blog.

    I know of at least one national company that may be in your area. I am sending you info privately if you’re still interested.

    Alice

  • Roni

    I am looking for a certified vasular access/PICC class or a PICC company who’s willing to train on the job. I am looking for more than just a 1-2 day class. I live in the Oklahoma City,Oklahoma area. I am a travel nurse as well, trying to stay local to be close to family. I would appreciate any info you can provide. Thanks Roni,RN

  • Hi Debbie, our PICC classes are held in sets of 2 consecutive days on the weekend. Our next classes will be held: July 30th, 31st and Sept. 24th, 25th 2011 in Stratford, Connecticut at the Homewood Suites Hotel. For details and a link to our flyer, travel info- go to http://www.piccresource.com/calendar.php
    My best,
    Alice

  • Debbie

    can you please send info on this class? date/time, cost, location, as I am a travel nurse and must get many of my own certifications and classes. thank you

  • Valarie

    Can you please send me info on picc line insertion classes and certification in any area close to Alabama that will be coming up in the future.I am a travel nurse so I don’t mind having to drive.I will greatly appreciate it.

  • Sure, we have training classes in Connecticut coming up soon- with openings in May 2011. Go to this link for more information and a link to the hotel info and travel information: http://www.piccresource.com/PICC_Spring_Travel-2011.pdf

    Alice

  • susan

    would like information on training or school to become certified for picc lines , Thanks,

  • It is a good idea to get updated in the current protocols. Standards and guidelines for insertion and care of PICC lines have changed a lot within the past 4 years. For example, there is a major effort in vascular access in general to eradicate central line associated blood stream infections, and there are many new protocols that have changed the way we practice PICC line insertion and care procedures.

    You can get updated by taking a PICC insertion class, and being precepted in your initial insertions using the new techniques. Your credentialing as competent in the procedure (aka certification) can be accomplished by meeting your employing facility’s requirements. Make sure that you save documentation that you have met the competency requirements, and going forward to keep up with changes in clinical practice you can join or subscribe to the journals of the Infusion Nurses Society (INS) and/or the Association for Vascular Access (AVA) . Both of these organizations offer continuing education through their conferences and journal publications, and both have local state based chapters (INS more chapters). We also plan to release a PICC and Midline update program that will be available on our website in our online classes section soon.

  • Sue

    I was certified in 1991, by going to a class and then successfully placing 3 lines while being observed. Since then I have changed positions and have not placed any in about 4 years. I am now in PICU instead of NICU. Do you think I need to recertify or what do you suggest?

  • Done, sent to your email privately.

  • SSanders, RN

    please send any information about PICC line certificaiton classes available. I live in Western KY. Thank you for and help provided.

  • Hello Kim,

    I hope you do not mind a repeat answer to your post. I believe I answered privately initially, but in reviewing the blog- I found the post answer would benefit others as well.

    To start a switch over from another specialty to IV nursing some of the easiest ways I suggest are to: either join an IV team at an inpatient hospital, or become a staff nurse at a home infusion pharmacy (examples are companies such as Bioscrip, Apria, Walgreens- and YES Walgreens is in home infusion now!), or working in an infusion center or clinic. In most cases these jobs focus your work in the area of IV care where you’d be exposed to all types of IV Central lines, and performing IV insertion procedures, and troubleshooting vascular access and infusion problems. If a full time job is not available; often per diem jobs are.

    Particularly in home infusion work where you’d work very independently; it is imperative that you have very good to excellent IV insertion skills. Being PICC certified in advance (or have successfully completed a PICC insertion class) is often an added plus in your favor to be accepted to work in home infusion. I am defining PICC certified here as: established as competent and independent in PICC insertion and care procedures after completion of a PICC insertion and care education program, and completion of competency/ credentialing criteria that meet current evidence-based standards of care and guidelines- whew! That’s a mouthful!

    Many home infusion companies see it as a plus if you have already completed a PICC insertion class (care is – part of a good PICC insertion class); and the companies will often have experienced PICC nurses on staff approved as preceptors and these nurses will supervise you in your initial PICC insertions as well as supervise your initial patient visits to verify competency in other procedures. You may also start working in home infusion in some areas with just performing PICC and central line care after completing the company’s competency / credentialing assessments and orientation training, and as a bonus they will send you to learn PICC insertions later on after you’ve been with the company for awhile. The latter is rarer as the nursing jobs become more scarce, and just like other nursing specialties- experience and education counts.

    Once you have a good number of hours over 2 to 3 years the specialty; you can apply to take an exam and become certified to validate you as a specialist (see the INCC and VACC sites by clicking on the name links here for specific details). Prior to this it helps to join a couple of the leading infusion nursing organizations such as the INS (Infusion Nurses Society), and AVA (Association for Vascular Access) or their local chapters to keep abreast of the latest information and changes in the field. For more info on these and other infusion/ vascular access organizations, go to the links to their sites on our website “About Us” page at http://www.piccresource.com/about_us.php . I hope this helped answer most of your questions.

    Cheers,

    Alice

  • Hello,
    It appears you were certified in-house only by meeting your employer’s requirements. However, when one is the only RN pioneering a PICC program at a facility; credentialing policies and procedures may not have been fully established at the time of your training. In-house certifications are not always portable. Plenty of nurses become certified using employer based in-house credentialing policies and procedures. But the full training process must be documented, and it should be evidence-based (based on current professional standards and guidelines of practice)- as I am sure you are finding out.

    There are private companies (one in particular) offering picc certification programs where you can become credentialed by a private picc education company. As you read the rest of my post, do not take what I am writing to mean that I am against credentialing by private education companies (I run one myself); just note that there is a new option. As of this year the Association for Vascular Access (AVA) has formed a certification organization arm – the Vascular Access Certification Corporation (VACC) to grant certification in vascular access; with the first exam offered this December.

    I feel a certification in vascular access is a better choice to pursue at this point. Here’s my reasoning on this point: most PICC nurses are also IV/Infusion nurses who are in general very skilled in care, management, and troubleshooting all types of vascular access devices including PICC Lines and other central lines. AVA is an U.S. based and internationally recognized leading organization that exists to advance and improve vascular access practices. A board certification from an organization such as this will be more highly accepted, and portable from job to job than an in-house credential. A vascular access certification would validate expertise in PICC insertion and care plus much more.

    PICC nurses are in some areas moving to placing CLs in IJs, etc. (they are calling them PICCs- I call it a CL; but when is a PICC not a PICC? I am off the subject, this is another topic to blog on).

    The point is, with new technology available PICC nurses are advancing their skill sets. Having a broader certification in vascular access is more in line with the roles that PICC nurses serve in their jobs as Vascular Access/IV/infusion/PICC resource nurses. Click here for a link to AVA’s web page on the VACC certification program. The application period for this year’s exam may be closed, but it will be offered again in 2011.

  • L. Jackson

    Good evening
    I was “certified” for PICC insertion and was the only RN at my previous hospital to perform such duties. I would like the information to become officially certified and recogized. As I have learned after applying for many many IV team , PICC certified postions, I did not meet the certification process. I was trained in a two week comprehensive BARD class through the hospital that I previously worked. Please send me the information as well for the proper certification(s).

    Thank you kindly

    L. Jackson,RN

  • kim

    I am interested in entering infusion services for home care. I recently had an job opportunity that I was not able to fulfill due to lack of my infusion knowledge and experience. I would like to get my certification, as an RN. Would you be able to guide me as to how best attain this goal?
    I have had previous IV insertion experience, however, that is over 10 yrs ago in a hospital setting – from NICU
    to Cardiac Telemetry. I now have an idea as to the need for certification to further my career goals in home care. Would you be able to also explain the difference between certication, and being certified.
    I would appreciate any assistance, and clarification.
    I am licensed in NY, and would you be able to suggest
    the courses and where I can get the necessary cont
    education to become an Infusion Nurse.
    Thanks for your help!
    Sincerely, Kim Telano, RN

  • Yes, there are neonatal and specifically pediatric focused PICC insertion classes. We offer classes for PICC insertion and care in adults and the older- school age child. I will send you info via email of a company that offers pediatric PICC classes in Atlanta, Georgia area.

    Alice

  • Tmortenson RN

    Is there additional certification required for placing pediatric mid or PICC lines.

Leave a Reply

  

  

  

You can use these HTML tags

<a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>