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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
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Inappropriate Use of Peripherally Inserted Central Catheters in Pediatrics: A Multisite Study
Alina G Burek1,2, Mary Beth Davis3,4, Brittany Pechous3
1Children's Wisconsin, Milwaukee, Wisconsin.
Hospital Pediatrics
|February 26, 2024
Summary
While most peripherally inserted central catheters (PICCs) were appropriate, a significant number were not. This highlights an opportunity to improve PICC use in hospitalized children through quality initiatives.
Area of Science:
- Pediatric hospital medicine
- Vascular access devices
- Healthcare quality improvement
Background:
- Peripherally inserted central catheters (PICCs) are widely used in pediatric hospital settings.
- Standardized guidelines, such as the Michigan Appropriateness Guide for Intravenous Catheters (miniMAGIC) in Children, aim to optimize PICC utilization.
- Variations in PICC use and appropriateness across institutions necessitate evaluation.
Purpose of the Study:
- To assess the alignment of current PICC practices in hospitalized children with miniMAGIC in Children guidelines.
- To identify variations in PICC appropriateness across different clinical sites.
- To characterize children receiving PICCs that do not meet appropriateness criteria.
Main Methods:
- Retrospective study at 4 US children's hospitals (January 2019-December 2021).
- Included hospitalized children with PICCs (excluding NICU patients).
- Categorized PICCs as appropriate, inappropriate, or uncertain appropriateness using miniMAGIC criteria.
Main Results:
- Of 6051 PICCs, 82% were appropriate, 9% inappropriate, and 9% uncertain.
- Up to 20% of PICCs annually were not appropriate, with inter-site variability.
- Inappropriate/uncertain PICCs (n=1100) were often for prolonged antibiotic courses (56%) and associated with complications (6%), mainly dislodgement (3%) and occlusion (2%).
Conclusions:
- The majority of PICCs met appropriateness criteria, but a notable proportion did not.
- Significant opportunities exist for quality improvement in PICC utilization among hospitalized children.
- Further research and targeted interventions can optimize PICC use and reduce associated complications.
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