Evaluation of a Unique, Nurse-Inserted, Peripherally Inserted Central Catheter Program

Gamulka, Beth; Mendoza, Cristina; Connolly, Bairbre

doi:10.1542/peds.2004-0542

Cited by 37 publications

(45 citation statements)

References 7 publications

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“…Peripherally Inserted Central Catheter (PICC) have been used in neonates for more than 20 years, as well as in children undergoing chemotherapy [16][17][18][19] or treatment for infectious diseases [20]. It has been shown in such populations that PICCs are more stable than short peripheral cannulae and need less frequent replacement [7,9,16].…”

Section: Introductionmentioning

confidence: 99%

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Intravenous peripherally-inserted central catheters for antibiotic therapy in children with cystic fibrosis

Bui

Babre

Hauchecorne

et al. 2009

Journal of Cystic Fibrosis

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Section: Introductionmentioning

confidence: 99%

“…It has been shown in such populations that PICCs are more stable than short peripheral cannulae and need less frequent replacement [7,9,16]. Their use has resulted in greater comfort in young patients [9].…”

Section: Introductionmentioning

confidence: 99%

Intravenous peripherally-inserted central catheters for antibiotic therapy in children with cystic fibrosis

Bui

Babre

Hauchecorne

et al. 2009

Journal of Cystic Fibrosis

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“…That incidence of malposition is similar to the incidences reported in other studies. 32,38,39 Malpositioned tips were located in the upper or middle third of the SVC, the ipsilateral subclavian vein, the right atrium, the ipsilateral internal jugular vein, and the axillary vein. In 1 case, the tip was coiled in the SVC (Table 3).…”

Section: Resultsmentioning

confidence: 99%

“…The tip locations and incidences are similar to those reported in other studies. 32,38,39 These reports show that about 58% of malpositions were corrected with catheter exchange, and 83% were corrected by repositioning the catheter in the interventional radiology division under imaging guidance. 32,38,39 In this study, we demonstrated a modification of PICC insertion: taking the chest radiograph earlier, which makes it easier to correct malpositions at the bedside, with high success rates and without catheter exchange.…”

Section: Discussionmentioning

confidence: 99%

Modified Insertion of a Peripherally Inserted Central Catheter: Taking the Chest Radiograph Earlier

Tian

Chen

et al. 2011

Critical Care Nurse

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Placement of the tip of a peripherally inserted central catheter in the lower third of the superior vena cava is essential to minimize the risk of complications. Sometimes, however, the catheter tip cannot be localized clearly on the chest radiograph, and repositioning a catheter at bedside is difficult, sometimes impossible. A chest radiograph obtained just after the catheter is inserted, before the guidewire is removed, can be helpful. With the guidewire in the catheter, the catheter and its tip can be seen clearly on the radiograph. If the catheter was inserted via the wrong route or the tip is not at the appropriate location, the catheter can be repositioned easily with the guidewire in it. Between January 1, 2007, and May 31, 2009, 225 catheters were placed by using this method in our department. Of these, 33 tips (14.7%) were initially malpositioned. The tips of all these catheters were repositioned in the lower third of the superior vena cava by using this method. No catheter was exchanged or removed. The infection rate for catheter placement did not increase when this method was used. This modification facilitates accurate location of the catheter tip on the chest radiograph, making it easy to correct any malposition (by withdrawing, advancing, or even reinserting the catheter after withdrawal).

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“…28 Bedside PICC placement can also present additional challenges related to limited workspace, suboptimal access to patients, infection control, and lack of access to additional equipment, if needed. [29][30][31][32] Before the start of the PICC team centralization, an effective decision-making process to determine the appropriate location for PICC insertion had not been established, resulting in a large number of unnecessary bedside placements. Because we believed this was not the safest option for all patients, 28 we investigated the reasons why bedside PICC insertions were requested.…”

Section: Locationmentioning

confidence: 99%

Proactive Planning for Vascular Access Therapy: One Hospital's Plan for Success

DeCastro

Eades

Rineair

et al. 2014

Journal of the Association for Vascular Access

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Background: Vascular access is a critical component of care for patients in neonatal intensive care units (NICUs). Our NICU had only a small number of nurses cross-trained to perform peripherally inserted central catheter (PICC) insertions and was not able to provide coverage 24 hours a day, 7 days a week. We combined the vascular access team (VAT) and NICU PICC team to improve the timeliness of NICU PICC insertions, standardize care, and use ultrasound for all PICC placements. Methods: A paper guide tool was developed to prioritize PICC placements as emergent, same-day, or nonemergent. NICU nurses were trained to insert PICCs using ultrasound. Catheter insertion and care processes were standardized for the new centralized PICC team. NICU and VAT staff worked together to improve daily communication, hand-offs, and referrals. Criteria were developed to determine the appropriate hospital location for PICC insertions. Charge nurses began capturing information about patients with PICCs on daily planning sheets. Results: Following implementation of the new combined VAT, the average wait time for emergent and same-day insertions decreased 10%. No adverse events were reported due to a delay in PICC placement or the PICC referral process. Conclusions: Combining the NICU PICC insertion nurses and the VAT into a new centralized PICC team provided an opportunity for growth in both areas. NICU PICCs are now placed efficiently based on patient acuity and referral prioritization throughout the hospital. NICU and VAT physicians and nurses have developed a strong partnership for the provision of PICC services for NICU patients.

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Evaluation of a Unique, Nurse-Inserted, Peripherally Inserted Central Catheter Program

Abstract: This novel, pediatric nurse-inserted PICC program has a good safety profile, high success rate, and low postprocedural complication rate.

Cited by 37 publications

References 7 publications

Intravenous peripherally-inserted central catheters for antibiotic therapy in children with cystic fibrosis

Intravenous peripherally-inserted central catheters for antibiotic therapy in children with cystic fibrosis

Modified Insertion of a Peripherally Inserted Central Catheter: Taking the Chest Radiograph Earlier

Proactive Planning for Vascular Access Therapy: One Hospital's Plan for Success

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