Peripherally inserted central catheters placed by a nurse-led vascular access team: Initial outcomes from a prospective single-center study

In many healthcare systems, PICCs are inserted by nurses working within dedicated vascular access teams (VAT). Evidence indicates that nurse-led VAT models achieve high technical success and acceptable complication rates when supported by standardized ultrasound-guided pathways. Despite this evidence, implementation remains inconsistent across Europe. This is the first prospective observational study in Poland evaluating nurse-led PICC insertion within a VAT model.

The study evaluated outcomes of a nurse-led PICC insertion pathway implemented within a hospital VAT. The primary endpoint was first-attempt venipuncture success; overall technical success was an additional outcome. Secondary endpoints included tip position, catheter-related complications, and catheter function. Adult patients (⩾18 years) requiring central vascular access and able to provide written informed consent were eligible. PICCs were inserted by VAT nurses trained in ultrasound-guided vascular access, each with at least 4 years of experience and more than 500 successful midline catheter insertions. Procedures were performed under physician oversight required by the Polish legal, institutional, and bioethics framework.

During the study period, 127 patients underwent attempted PICC insertion. Ten were not enrolled because they could not provide written informed consent, leaving 117 patients for analysis. First-attempt venipuncture was achieved in 109 procedures (93.2%; 95% CI, 87.1-96.5%), while two attempts were required in eight cases (6.8%). PICC insertion was technically successful in 112 cases (95.7%). In 79 patients (67.5%), VAT assessment resulted in PICC placement instead of the planned CICC. Full catheter patency was maintained in 110 of 112 PICCs (98.2%). Premature removal due to catheter-related complications occurred in 16 cases (14.29%; 95% CI, 7.80-20.77%).

A nurse-led PICC insertion pathway embedded within a VAT can be implemented safely and effectively in Poland. High procedural success, sustained catheter patency, and frequent avoidance of planned CICC placement indicate potential clinical and organizational benefits.

PICC Inserted by a Nurse-led Vascular Access Team in Poland (NIce-PICC; NCT06979128) https://clinicaltrials.gov/study/NCT06979128?locStr=Poland&country=PL&cond=PICC&viewType=Card&rank=1.