Quality Improvement Initiative Reduces the Occurrence of Complications in Peripherally Inserted Central Catheters

Peripherally inserted central catheters (PICCs) are commonly used to access the central venous system. However, central vascular access devices are associated with a risk of complications, which may include infection, thrombosis, occlusion, or malposition. The vascular access team of 1 midwestern hospital used a quality improvement initiative to reduce the occurrence of complications associated with PICCs. A secondary aim was to reduce the number of alteplase (Cathflo Activase; Genentech, South San Francisco, CA) doses administered. After reviewing current evidence, the vascular access team employed the Plan-Do-Study-Act cycle to document and implement changes in practice. By using a team initiative to investigate this issue, complication rates decreased and patient satisfaction improved. The thrombosis rate decreased by 67%, occlusions by 75%, and alteplase use by 87%. No infections occurred during this study.