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Peripherally Inserted Central Catheter Use in Skilled Nursing Facilities: A Pilot Study.

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Peripherally inserted central catheters (PICCs) in skilled nursing facilities (SNFs) show frequent complications and inconsistent care documentation. Quality improvement initiatives are needed to enhance PICC management and patient outcomes in SNFs.

Keywords:
central line-associated bloodstream infectiondeep vein thrombosisperipherally inserted central catheterskilled nursing facilityvenous thromboembolism

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Area of Science:

  • Medical Devices
  • Infectious Disease Prevention
  • Geriatric Care

Background:

  • Peripherally inserted central catheters (PICCs) are increasingly used in skilled nursing facilities (SNFs) for various indications.
  • Understanding the current practices and outcomes associated with PICC use in SNFs is crucial for improving patient care.
  • Limited data exists on the specific challenges and complications encountered with long-term PICC management in this setting.

Purpose of the Study:

  • To describe the patterns of peripherally inserted central catheter (PICC) use in skilled nursing facilities (SNFs).
  • To evaluate the care practices and document the outcomes associated with PICC insertion and maintenance in SNFs.
  • To identify common complications and areas for quality improvement in PICC management within SNF settings.

Main Methods:

  • A prospective cohort study was conducted in two community skilled nursing facilities.
  • Data were collected from medical records of 56 adult SNF residents with PICCs, including indications, device characteristics, and comorbidities.
  • Care practices, complications (major and minor), and process measures were systematically recorded and analyzed using bivariate statistics.

Main Results:

  • The primary indication for PICC placement was intravenous antibiotic delivery, with an average dwell time of 43 days.
  • Major complications occurred in 20% of participants, and minor complications in 32%, with occlusion (23%) and dislodgement (12%) being most frequent.
  • Documentation of catheter care practices was noted in only 41% of cases, highlighting a significant gap in care consistency.

Conclusions:

  • PICC use in SNFs is associated with a high incidence of complications and suboptimal care documentation.
  • There is a clear need for quality improvement initiatives to standardize and enhance PICC care practices in skilled nursing facilities.
  • Benchmarking practices and identifying specific gaps are essential steps toward improving patient safety and outcomes related to PICCs in SNFs.