Comparing peripherally inserted central catheter-related practices across hospitals with different insertion models:...

Area of Science:

• Medical Devices
• Vascular Access
• Healthcare Management

Background:

• Peripherally inserted central catheters (PICCs) are vital for parenteral therapy.
• Current knowledge on PICC care practices and inter-hospital variations is limited.
• This study compares PICC processes across different hospital insertion models.

Purpose of the Study:

• To compare peripherally inserted central catheter (PICC) related processes across hospitals with varying insertion delivery models.
• To identify best practices and areas for improvement in PICC care.
• To understand the impact of different organizational structures on PICC management.

Main Methods:

• Descriptive qualitative methodology with semistructured interviews at five Veterans Affairs Medical Centres.
• Sites included facilities with vascular access teams (VATs), interventional radiology (IR) led PICC insertion, and no on-site capability.
• Data collected from 56 healthcare personnel across four PICC domains: use, insertion, management, and discharge education.

Main Results:

• Dedicated VATs demonstrated benefits across all PICC process domains.
• VATs facilitated criteria-based PICC placement, timely insertion, robust management, and clear discharge education.
• Areas for improvement include clinician awareness of appropriateness criteria, alternative devices, VAT deployment, and patient education.

Conclusions:

• Vascular access nurses are central to all aspects of PICC care.
• Significant variation exists in PICC decision-making, care, maintenance, and patient education across hospitals.
• Opportunities for quality and safety improvement exist to standardize and enhance PICC care.