PICC line

Care & Maintenance of PICC Lines: A Practical Guide for Nurses

What is a PICC Line?

A PICC line (Peripherally Inserted Central Catheter) is a long, thin catheter inserted into a peripheral vein, typically in the upper arm, and advanced until its tip lies in a large central vein—most often the lower third of the superior vena cava or cavo-atrial junction.
In short, it’s a type of central venous access device (CVAD) used for longer-term IV therapy, infusions with high osmolarity, or medications that would irritate smaller peripheral veins.

Key features for nurses to remember:

  • Catheter gauge is typically 3–6 Fr and about 50–60 cm long in adults.
  • May be single or multi-lumen, valved or non-valved, and sometimes power-injectable.
  • Allows delivery of TPN, antibiotics, chemotherapy, and blood products while reducing the need for repeated venipunctures.

Pros & Cons of PICC Lines

Pros

  • Provides reliable long-term vascular access.
  • Reduces need for multiple needle sticks.
  • Suitable for inpatient, outpatient, and home health use.
  • Lower risk of pneumothorax than subclavian or jugular lines.

Cons / Risks

  • Risk of catheter-related bloodstream infections (CRBSI).
  • Potential for thrombosis or occlusion.
  • Requires skilled maintenance and strict aseptic technique.
  • Possible contraindications in certain patient populations (e.g., upper extremity DVT history, future dialysis plans).

Care and Maintenance Guidelines for PICC Lines

The following nursing summary is based on the Guide to PICC Maintenance provided by Pedagogy Education.

Nurses can print this guide for unit use to keep at the IV supply station or include in competency binders.

Accessing the System

  • Scrub the hub for 15–30 seconds with alcohol or use an approved disinfecting cap before each access.

Blood Draws

  • Use a 10 mL or larger syringe.
  • Flush with 10 mL NS before and 20 mL after the draw.

Site Assessment

  • Inspect each shift for redness, swelling, tenderness, or drainage.
  • Remove the PICC when no longer clinically necessary.

Flushing and Locking

  • Use a 10 mL syringe and push–pause method.
  • Non-valved devices: flush daily; valved devices: flush weekly.

Needleless Connector Changes

  • Change with the administration set or every 7 days, and after blood draws.

Dressing & Securement

  • Use sterile technique and a transparent dressing.
  • Change dressing every 7 days or sooner if soiled or loose.
  • Use an antimicrobial disc per policy and label with date/time/initials.

Special Considerations & Best Practices

  • Verify tip position before use after insertion.
  • Educate patients to report pain, fever, or swelling immediately.
  • Avoid submerging the PICC arm or heavy lifting unless cleared.
  • Document all maintenance tasks and assessments thoroughly.
  • Remove promptly once therapy is complete.

Continuing Education for Nurses: Master PICC Line Care

PICC line care is a critical nursing skill that demands current knowledge and competency. To strengthen your clinical expertise, explore Pedagogy Education’s continuing education course:
👉 It’s All About PICCs

This online course covers PICC insertion principles, daily care, dressing protocols, troubleshooting, and prevention of complications — ideal for nurses in acute care, home health, and long-term care settings who manage vascular access devices.

Conclusion

When properly maintained, a PICC line provides reliable and comfortable vascular access for patients requiring long-term therapy. Diligent nursing care — including hub disinfection, flushing, dressing changes, and site assessment — is key to preventing infection and maintaining line patency.

Nurses can access and print Pedagogy’s Guide to PICC Maintenance for unit reference, supporting consistent, evidence-based PICC management across all care settings.

References