Development and Implementation of a Bedside Peripherally Inserted Central Catheter Service in a PICU.

Authors:

Thomas W Conlon Adam S Himebauch Anne Marie Cahill Blair M Kraus Chinonyerem R Madu Mark D Weber Carol A Czajka Ruby L Baker Torron M Brinkley Melanie D Washington Anne Marie Frey Eileen M Nelson Cara T Jefferies Charlotte Z Woods-Hill Heather A Wolfe Daniela H Davis

Pediatr Crit Care Med 2019 01;20(1):71-78

Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA.

Objectives: To create a bedside peripherally inserted central catheter service to increase placement of bedside peripherally inserted central catheter in PICU patients.

Design: Two-phase observational, pre-post design.

Setting: Single-center quaternary noncardiac PICU.

Patients: All patients admitted to the PICU.

Interventions: From June 1, 2015, to May 31, 2017, a bedside peripherally inserted central catheter service team was created (phase I) and expanded (phase II) as part of a quality improvement initiative. A multidisciplinary team developed a PICU peripherally inserted central catheter evaluation tool to identify amenable patients and to suggest location and provider for procedure performance. Outcome, process, and balancing metrics were evaluated.

Measurements And Main Results: Bedside peripherally inserted central catheter service placed 130 of 493 peripherally inserted central catheter (26%) resulting in 2,447 hospital central catheter days. A shift in bedside peripherally inserted central catheter centerline proportion occurred during both phases. Median time from order to catheter placement was reduced for peripherally inserted central catheters placed by bedside peripherally inserted central catheter service compared with placement in interventional radiology (6 hr [interquartile range, 2-23 hr] vs 34 hr [interquartile range, 19-61 hr]; p < 0.001). Successful access was achieved by bedside peripherally inserted central catheter service providers in 96% of patients with central tip position in 97%. Bedside peripherally inserted central catheter service central line-associated bloodstream infection and venous thromboembolism rates were similar to rates for peripherally inserted central catheters placed in interventional radiology (all central line-associated bloodstream infection, 1.23 vs 2.18; p = 0.37 and venous thromboembolism, 1.63 vs 1.57; p = 0.91). Peripherally inserted central catheters in PICU patients had reduced in-hospital venous thromboembolism rate compared with PICU temporary catheter in PICU rate (1.59 vs 5.36; p < 0.001).

Conclusions: Bedside peripherally inserted central catheter service implementation increased bedside peripherally inserted central catheter placement and employed a patient-centered and timely process. Balancing metrics including central line-associated bloodstream infection and venous thromboembolism rates were not significantly different between peripherally inserted central catheters placed by bedside peripherally inserted central catheter service and those placed in interventional radiology.

Download full-text PDF	Source
http://dx.doi.org/10.1097/PCC.0000000000001739	DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322932	PMC

January 2019

Publication Analysis

Top Keywords

peripherally inserted

venous thromboembolism

interventional radiology

central line-associated

bloodstream infection

line-associated bloodstream

Keyword Occurance

Similar Publications

Breakthrough daptomycin-, linezolid-, vancomycin-resistant bacteremia during protracted daptomycin therapy: A case report.

Authors:

Nathan B Pincus Tejas Joshi Samuel W M Gatesy Omar Al-Heeti W Justin Moore Kelly E R Bachta

IDCases 2022 4;29:e01593. Epub 2022 Aug 4.

Division of Infectious Diseases, Northwestern University, Feinberg School of Medicine, Chicago, IL, the United States of America.

Infections with multidrug resistant (MDR) () are a growing problem. Vancomycin resistance in enterococci has long challenged treatment, necessitating the use of linezolid or daptomycin. Subsequently, daptomycin-, linezolid-, vancomycin-resistant (DLVRE) infections have emerged. Read More

View Article and Full-Text PDF

August 2022

Similar Publications

Therapeutic Effect of Ultrasound-Guided Peripherally Inserted Central Catheter Combined with Predictive Nursing in Patients with Large-Area Severe Burns.

Authors:

Baiyan He Aiqiong Zhang Shuting He

Comput Math Methods Med 2022 31;2022:1019829. Epub 2022 Jul 31.

Department of Burn and Plastic Surgery, Central Hospital of the First People's Hospital, Chenzhou, 423000 Hunan, China.

This study was aimed to explore the application value of ultrasound-guided peripherally inserted central catheter (PICC) combined with predictive nursing in the treatment of large-area severe burns. 88 patients with large-area severe burns who visited hospital were chosen as the research objects. They were randomly divided into the observation group and the control group, with 44 cases in each. Read More

View Article and Full-Text PDF

August 2022

Similar Publications

The incidence and risk of venous thromboembolism associated with peripherally inserted central venous catheters in hospitalized patients: A systematic review and meta-analysis.

Authors:

Anju Puri Haiyun Dai Mohan Giri Chengfei Wu Huanhuan Huang Qinghua Zhao

Front Cardiovasc Med 2022 26;9:917572. Epub 2022 Jul 26.

Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Background: Venous thromboembolism (VTE) can be fatal if not treated promptly, and individual studies have reported wide variability in rates of VTE associated with peripherally inserted central catheters (PICC). We thus conducted this meta-analysis to investigate the overall incidence and risk of developing PICC-related VTE in hospitalized patients.

Methods: We searched PubMed, Embase, Scopus, and Web of Science databases from inception until January 26, 2022. Read More

View Article and Full-Text PDF

July 2022

Similar Publications

Catheter-related bloodstream infections in infants hospitalized in neonatal intensive care units: a single center study.

Authors:

Julian F Kochanowicz Agnieszka Nowicka Salwan R Al-Saad Lukasz M Karbowski Janusz Gadzinowski Dawid Szpecht

Sci Rep 2022 Aug 11;12(1):13679. Epub 2022 Aug 11.

Chair and Department of Neonatology, Poznan University of Medical Sciences, Poznan, Poland.

Sepsis in neonates carries a high morbidity and mortality rate and is among the most feared complications in the neonatal intensive care unit (NICU). Catheter-related bloodstream infections (CRBSI) are a common etiology of late-onset sepsis. The aim of this study was to compare risk factors and characteristics between patients according to the type of catheter that was utilized and according to birth weight classification. Read More

View Article and Full-Text PDF

August 2022

Similar Publications

Midline Catheters: A 3-Year Experience at a Veterans Administration Medical Center.

Authors:

Andrew Johnson Ashwin Gupta Tristan Feierabend Tracy Lopus Richard Schildhouse David Paje

Am J Infect Control 2022 Aug 7. Epub 2022 Aug 7.

The Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI; Veterans Administration Ann Arbor Healthcare System, Ann Arbor, MI. Electronic address:

Objective: Midline catheters are recommended over peripherally inserted central catheters as short-term vascular access device for peripherally compatible infusates. We assessed the effectiveness and safety of midline catheters.

Methods: Data from midline catheter placements from 06/2016-05/2019 at a tertiary-care Veterans Administration medical center were retrospectively collected. Read More

View Article and Full-Text PDF

August 2022

Similar Publications

}

Search Our Scientific Publications & Authors