United States Department of Veterans Affairs

VA Western New York Healthcare System

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TCS Procedure: Safer, Faster
Photo of VA nurses standing in front of a ECG Waveform Tip Confirmation machine
From left to right: Michele Ford, Nurse Manager 9B/PICC Team, Teresa Nati RN, Terry Maclin RN, Sherrie Parish RN and Kathleen Arnold RN.

VA Western New York Healthcare System is the first hospital in the region to implement the ECG Waveform Tip Confirmation System (TCS) to locate the placement of a peripherally inserted central catheter (PICC).

A physician may order a PICC for a variety of reasons including intravenous nutrition, antibiotic therapy or some chemotherapy regimens. The normal method for finding the tip of the PICC is by X-ray. The new method provides real-time PICC tip location information by using the patient’s cardiac electrical activity.

TCS is faster and allows for more accurate placement, which is better for the patient and allows for quicker use of the line. Patients also receive the benefits of less discomfort and decreased complication risk. Clinical studies have found the system to be 97 percent accurate on the first try.

“By monitoring a patient’s heartbeat and ECG pattern, the PICC nurses can pinpoint the catheter tip’s location, which reduces the radiation exposure to patients and shortens the time the procedure takes,” noted Michele Ford RN, Nurse Manager for the PICC Team.

VA Western New York Healthcare System uses a PICC team of five registered nurses, who place an average of 40 PICC lines per month. This specially trained group of registered nurses includes Sherrie Parish, Mary Rieman, Theresa Nati, Terry Maclin, and Kathleen Arnold. The nurses learned about the new device to become the first hospital in the Western New York region and the thirty-seventh in the nation to begin using the technology.