Preventing intraluminal occlusion in peripherally inserted central catheters.

Area of Science:

• Vascular Access Devices
• Medical Device Complications
• Patient Safety

Background:

• Peripherally inserted central catheters (PICCs) are widely used but prone to infective and thrombotic complications.
• Complications such as persistent withdrawal occlusion (PWO) and complete luminal occlusion in PICCs are less frequently reported but significantly impact patient care.
• Existing data on PWO and occlusion rates in PICCs is limited, necessitating further investigation.

Purpose of the Study:

• To audit the incidence of PWO and complete luminal occlusion in PICCs.
• To evaluate the impact of introducing a bi-directional needle-free connector on PICC occlusion rates.
• To assess potential financial implications associated with PICC complications and interventions.

Main Methods:

• An initial audit reviewed clinical documentation, departmental databases, and physical patient reviews for PICCs over a 6-week period.
• Following the introduction of a bi-directional needle-free connector, data was collected on 180 PICCs inserted over 12 months.
• Vascular access teams and clinical nurse specialists provided input on complication rates and management.

Main Results:

• The initial audit suggested an estimated PICC occlusion rate of 5%, likely an underestimate.
• After implementing the bi-directional needle-free connector, the PWO rate decreased to 1/1000 catheter days.
• The total occlusion rate dropped to 0.4/1000 catheter days, with complications occurring between 9 to 144 days post-insertion.

Conclusions:

• The introduction of a bi-directional needle-less connector demonstrated a positive impact on reducing PWO and occlusion rates in PICCs.
• Despite initial data limitations, the findings support the efficacy of the new connector in improving PICC functionality and patient safety.
• Further research with robust baseline data is recommended to confirm these findings.