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Author Spotlight: Hickman Catheter Use for Long-Term Vascular Access in a Preclinical Swine Model

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A Tunneled Catheter Placement Program for Community Hospices.

Ned Stolzberg¹, Gobi Paramanandam², Shelly R Myers¹

¹Hospice of the Valley (N.S., S.M., S.A.), Phoenix, Arizona, USA.

Journal of Pain and Symptom Management

|November 22, 2023

Summary

Hospice patients with ascites or pleural effusions can benefit from an in-house tunneled catheter program. This pilot study shows it is feasible, cost-effective, and improves quality of life.

Keywords:

Hospice ascites palliative pleural effusion tunneled catheter

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Area of Science:

Palliative Care
Medical Devices
Symptom Management

Background:

Excessive fluid accumulation (ascites, pleural effusions) causes intractable symptoms in hospice patients.
Current management often involves outpatient procedures, impacting patient quality of life.
Hospice of the Valley sought an improved approach for symptom relief.

Purpose of the Study:

To describe an in-house pilot program for tunneled catheter placement in hospice patients.
To evaluate the feasibility, cost-effectiveness, and patient outcomes of this program.

Main Methods:

A retrospective review of 135 procedures on 127 hospice patients over 27 months (2020-2023).
Analysis of procedure-related and late complication rates.
Evaluation of program logistics, cost, and acceptance by hospice teams, patients, and families.

Main Results:

Low rates of procedure-related (<4%) and late (<3%) complications were observed.
The average cost per procedure ($1030) was favorable compared to outpatient providers.
The program demonstrated high acceptance among all stakeholders.

Conclusions:

An in-house tunneled catheter program is a feasible option for hospice providers.
This approach offers low-cost symptom relief and improved quality of life for selected patients.
The program effectively addresses intractable symptoms associated with fluid accumulation.