A National Survey of Neonatal Peripherally Inserted Central Catheter (PICC) Practices

Sharpe, Elizabeth L.; Pettit, Janet; Ellsbury, Dan L.

doi:10.1097/anc.0b013e318278b907

Cited by 75 publications

(85 citation statements)

References 55 publications

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“…5 Further research is required to determine whether the algorithm can be refined to identify earlier stages of IV infiltration. Grade 4 infiltrations were reduced and statistical significance ( P = .00021) was achieved.…”

Section: Discussionmentioning

confidence: 99%

Peripheral Intravenous and Central Catheter Algorithm

Wilder

Kuehn

Moore

2014

Advances in Neonatal Care

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Peripheral intravenous (PIV) infiltrations causing tissue damage is a global issue surrounded by situations that make vascular access decisions difficult. The purpose of this quality improvement project was to develop an algorithm and assess its effectiveness in reducing PIV infiltrations in neonates. The targeted subjects were all infants in our neonatal intensive care unit (NICU) with a PIV catheter. We completed a retrospective chart review of the electronic medical record to collect 4th quarter 2012 baseline data. Following adoption of the algorithm, we also performed a daily manual count of all PIV catheters in the 1st and 2nd quarters 2013. Daily PIV days were defined as follows: 1 patient with a PIV catheter equals 1 PIV day. An infant with 2 PIV catheters in place was counted as 2 PIV days. Our rate of infiltration or tissue damage was determined by counting the number of events and dividing by the number of PIV days. The rate of infiltration or tissue damage was reported as the number of events per 100 PIV days. The number of infiltrations and PIV catheters was collected from the electronic medical record and also verified manually by daily assessment after adoption of the algorithm. To reduce the rate of PIV infiltrations leading to grade 4 infiltration and tissue damage by at least 30% in the NICU population. Incidence of PIV infiltrations/100 catheter days. The baseline rate for total infiltrations increased slightly from 5.4 to 5.68/100 PIV days (P = .397) for the NICU. We attributed this increase to heightened awareness and better reporting. Grade 4 infiltrations decreased from 2.8 to 0.83/100 PIV catheter days (P = .00021) after the algorithm was implemented. Tissue damage also decreased from 0.68 to 0.3/100 PIV days (P = .11). Statistical analysis used the Fisher exact test and reported as statistically significant at P < .05. Our findings suggest that utilization of our standardized decision pathway was instrumental in providing guidance for problem solving related to vascular access decisions. We feel this contributed to the overall reduction in grade 4 intravenous infiltration and tissue damage rates. Grade 4 infiltration reductions were highly statistically significant (P = .00021).

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Section: Discussionmentioning

confidence: 99%

Peripheral Intravenous and Central Catheter Algorithm

Wilder

Kuehn

Moore

2014

Advances in Neonatal Care

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“…It was identified a lack of studies about this theme related to this specific population, being this, one of the limiting factors of the study. (9,(24)(25)(26)(27) Adherence to the use of bundle has shown significant results in reducing CLABSI in NICU, linked to permanent education practices. (9,26) A meta-analysis aimed at evaluating the efficacy of bundles of CLABSI prevention in neonatal, pediatric and adult Intensive Care Unit, identified that this strategy implementation in different countries presents positive results in costs reduction.…”

Section: Discussionmentioning

confidence: 99%

“…These gauges are recommended for higher safety. (24) The third item included the disinfection of the stopcocks and connections at each handling, with 70% alcohol by means of the strict friction with at least five circular movements. Such care provides significant reductions in the CLABSI, however, there is no consensus on the use of 70% alcohol and the alcoholic antiseptic solution of chlorhexidine gluconate in neonatology.…”

Section: Discussionmentioning

confidence: 99%

Bundle para manuseio do cateter central de inserção periférica em neonatos

et al. 2019

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Resumo Objetivo Construir um bundle para prevenção de infecção primária da corrente sanguínea relacionada a cateter que contemple cuidados de enfermagem para manuseio do cateter de acesso venoso central por inserção periférica em neonatos. Métodos Pesquisa metodológica, desenvolvida no ano de 2017 em três etapas: levantamento bibliográfico, construção do instrumento e validação de conteúdo por cinco juízes. O instrumento para validação foi composto por 21 cuidados de enfermagem selecionados na primeira etapa. O índice de validade de conteúdo acima de 80% foi utilizado para avaliar a concordância entre os juízes, esta etapa foi realizada em uma única rodada. Resultados Dos 21 itens avaliados pelos juízes, dez foram excluídos por apresentarem índice de validade de conteúdo menor que 0,80 e três foram agrupados ao demais cuidados elencados. A versão final do bundle foi composta por oito itens. Os cuidados incluídos foram relacionados a higienização das mãos antes e após as manuseio, o uso de seringas com calibre adequado, troca e desinfecção das dânulas e dos conectores com álcool 70%, teste de permeabilidade e cuidados com curativos. Conclusão O estudo permitiu elaborar e validar junto a juízes um bundle para manuseio do cateter central de inserção periférica em neonatos com vistas a redução de infecção primária da corrente sanguínea relacionada ao cateter de acesso venoso central por inserção periférica.

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“…12 , 13 Other surveys were actual reports of their own centers' practices and did not reflect multiple centers. 4 This national survey represented 25% of the level III NICUs from 43 states. 16 In 2010, this author conducted a national survey of neonatal PICC practices in the United States, which was published in 2013.…”

mentioning

confidence: 99%

Neonatal Peripherally Inserted Central Catheter Practices and Their Association With Demographics, Training, and Radiographic Monitoring

Sharpe¹

2014

Advances in Neonatal Care

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The goal of this secondary analysis of results from a national survey of peripherally inserted central catheters (PICCs) practices in neonates was to determine whether demographics and types of training were associated with differing radiographic confirmation practices of these catheters. Correlational analyses were performed on the 2010 national database of neonatal PICC practices. The sample consisted of 187 respondents, representing 25% of the level III neonatal intensive care units (NICUs) of more than 20 beds in the United States. The key factors examined were geographic location, size of NICU, academic affiliation, and type of training related to radiographic confirmation of the catheter tip position, routine monitoring and reconfirmation of the catheter tip position following adjustments, and associated patient positioning practices for consistent evaluation of the catheter tip position. Formal training and annual retraining were statistically significantly associated with consistent patient positioning practices for more accurate monitoring of the catheter tip position and acceptable tip location. Size of NICU and academic affiliation were not associated with differences in practices. Adherence to specific national guidelines and recommendations for care of infants with PICCs is significantly impacted by formal training and annual retraining. This underscores the importance of education and annual retraining in preventing PICC-related complications beyond the crucial prevention of central line-associated bloodstream infections.

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A National Survey of Neonatal Peripherally Inserted Central Catheter (PICC) Practices

Cited by 75 publications

References 55 publications

Peripheral Intravenous and Central Catheter Algorithm

Peripheral Intravenous and Central Catheter Algorithm

Bundle para manuseio do cateter central de inserção periférica em neonatos

Neonatal Peripherally Inserted Central Catheter Practices and Their Association With Demographics, Training, and Radiographic Monitoring

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