Decreasing Peripherally Inserted Central Catheter Use With Ultrasound-Guided Peripheral Intravenous Lines

Abstract

An ultrasound-guided peripheral intravenous (UGPIV) quality improvement project occurred in an 849-bed tertiary care hospital with a goal to reduce the use of central lines, in particular, peripherally inserted central catheters (PICCs). Since implementation, PICCs have decreased by 46.7% overall, and 59 nurses in-hospital are competent in placing UGPIVs. Placement of UGPIVs by the bedside nurse is a key initiative in decreasing PICC use and, potentially, infections.

Establishing the required components for training in ultrasoundguided peripheral intravenous cannulation: a systematic review of available evidence

“…First attempt peripheral intravenous cannulation success would, however, be improved if practitioners with greater procedural experience and an increased perception of the likelihood of success performes the cannulation. [49]. The use of ultrasound should be considered early if peripheral venous cannulation proves to be difficult [ 50].…”

Interventions to reduce unnecessary central venous catheter use to prevent central-line–associated bloodstream infections in adults: A systematic review

“…The 14 included studies were published between 2010 and 2018 and were performed in the United States, [15][16][17][18][19][20][21][22][23][24] Canada, 25,26 France, 27 and Thailand. 28 Of the eligible studies, 1 (7.1%) was a cluster RCT, 28 4 (28.6%) were cohort studies, [22][23][24]26 and 9 (64.3%) were QESs, including 5 before-and-after QESs, 15,16,18,25,27 3 interrupted time-series studies, [19][20][21] and 1 pilot study. 17 These studies were all conducted in adult departments; all patients were ≥18 years old.…”

“…Only 2 studies included all inpatients and observation patients. 16,18 Most studies included only a specific department: 5 studies implemented the intervention in the medical and/or surgical wards, 19,20,23,25,28 2 studies were performed in the emergency departments, 22,24 and 5 studies focused on patients in intensive care units only. 15,17,21,26,27 Only 4 studies (28.6%) specified the type of CVC used.…”

“…15,17,21,26,27 Only 4 studies (28.6%) specified the type of CVC used. [18][19][20]25 Morata, 18 Swaminathan, 20 and Reeves 19 included only peripherally inserted central venous catheters (PICCs). Grady 27 defined the CVCs as nontunneled; nondialysis catheters in jugular, subclavian, or femoral veins; or PICCs.…”

“…21 Another 3 studies did not specify the sample size. 18,19,23 The duration of data collection was variable from 1 month to 60 months, and some studies collected >1 set of preintervention or/and postintervention data. For our analysis, we used only the first preintervention and the final postintervention data.…”