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A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
Published on: July 13, 2019
Outcomes in a nurse-led peripherally inserted central catheter program: a retrospective cohort study
Sheryl McDiarmid1, Nicholas Scrivens1, Marc Carrier1
1Affiliations: The Ottawa Hospital (McDiarmid), Ottawa Hospital Research Institute (McDiarmid, Scrivens, Sabri); Department of Medicine (Carrier), Ottawa Hospital Research Institute at the University of Ottawa; Division of Microbiology and Infectious Diseases (Toye), University of Ottawa, The Ottawa Hospital; Department of Medicine (Huebsch), University of Ottawa, The Ottawa Hospital; Clinical Epidemiology Program (Fergusson), Ottawa Hospital Research Institute; Department of Medicine (Fergusson), University of Ottawa, Ottawa, Ont.
A nurse-led program significantly reduced major complications associated with peripherally inserted central catheters (PICCs). This study highlights the benefits of expert teams and standardized protocols in improving patient outcomes with PICC devices.
Area of Science:
- Vascular Access Devices
- Infection Control
- Patient Safety
Background:
- Peripherally inserted central catheters (PICCs) offer significant patient benefits but are associated with high complication rates.
- Recent publications indicate a need to address PICC-related complications.
- A nurse-led program was evaluated for patient and device outcomes.
Purpose of the Study:
- To evaluate patient and device outcomes in a nurse-led peripherally inserted central catheter (PICC) program.
- To assess the incidence of major PICC-associated complications.
- To determine the effectiveness of standardized protocols and expert teams in managing PICCs.
Main Methods:
- Retrospective analysis of a prospective cohort of 656 patients with BioFlo PASV PICCs.
- Data collected from January 1, 2013, to December 31, 2014.
- Measured incidence of catheter-related bloodstream infections, deep vein thrombosis, and thrombolytic use for occlusions.
Main Results:
- Low incidence of major complications: 0.6% for catheter-related bloodstream infections and 1.5% for deep vein thrombosis.
- Median dwell time was 45 days over 58,486 catheter days.
- Thrombolytic use was higher in dual-lumen catheters (25.7%) compared to single-lumen (7.1%).
Conclusions:
- Low complication rates attributed to a nurse-led expert insertion team, standardized care, high insertion volumes, and quality improvement.
- Peripherally inserted central catheters (PICCs) can be used with a low risk of major complications.
- Nurse-led programs are effective in optimizing PICC utilization and patient safety.
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