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Related Experiment Videos

Peripherally inserted central catheters: outcome as a function of the operator.

N I Fong1, S R Holtzman, M A Bettmann

  • 1Department of Radiology, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, New Hampshire, USA. nep@alum.dartmouth.org

Journal of Vascular and Interventional Radiology : JVIR
|June 5, 2001
PubMed
Summary

Trained registered nurses (RNs) can safely place peripherally inserted central catheters (PICCs), with complicated cases referred to interventional radiologists (IRs). This approach ensures cost-effectiveness and successful therapy completion for most patients.

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Radiology·2001

Area of Science:

  • Vascular Access Devices
  • Interventional Radiology
  • Nursing Practice

Background:

  • Peripherally inserted central catheters (PICCs) are crucial for long-term intravenous therapy.
  • Placement of PICCs is increasingly performed by various healthcare professionals.
  • Understanding the outcomes associated with different placement providers is essential for optimizing patient care.

Purpose of the Study:

  • To evaluate the natural history and outcomes of PICCs placed at a single academic medical center.
  • To compare the outcomes of PICCs placed by interventional radiologists (IRs) versus registered nurses (RNs).

Main Methods:

  • A prospective analysis of 322 PICC insertions (130 by IRs, 192 by RNs) over 6.5 months.
  • Patients were categorized by the provider performing the PICC insertion.

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  • Outcomes included successful placement, therapy completion, and reasons for premature removal (infection, occlusion, phlebitis, etc.).

    • Main Results:

    • Overall PICC success rate was 99.1%, with 69.3% of therapies completed.
    • The rate of premature PICC removal did not significantly differ between IRs and RNs (30.8% vs. 23.4%).
    • PICCs placed by IRs showed a higher incidence of occlusion (9.2% vs. 3.6%, P=.02).

    Conclusions:

    • Trained RNs can effectively place PICCs in feasible cases.
    • Complicated PICC placements should be referred to IRs.
    • This collaborative approach is reasonable, cost-effective, and supports successful therapy completion.