Hospitalist experiences regarding peripherally inserted central catheters (PICC)

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#IVTEAM #Intravenous literature: Chopra, V., Kuhn, L., Flanders, S.A., Saint, S. and Krein, S.L. (2013) Hospitalist Experiences, Practice, Opinions, and knowledge regarding peripherally inserted central catheters: Results of a national survey. Journal of Hospital Medicine. October 18th. [epub ahead of print].

Abstract:

BACKGROUND: A Michigan survey found variation in hospitalist-reported experience, practice, opinions, and knowledge related to peripherally inserted central catheters (PICCs). Whether these findings reflect a national trend is unknown.

OBJECTIVE: To investigate self-reported PICC practice among adult hospitalists in the United States.

METHODS: Society of Hospital Medicine-administered, anonymous, Web-based survey of practicing, adult, non-Michigan hospitalists.

RESULTS: Of the 2112 hospitalists who were sent an electronic invitation, 381 completed the online survey (18%). Eighty-six percent of hospitalists reported having placed a PICC solely for venous access (vs specific indications such as long-term antibiotics or parenteral nutrition). Eighty-two percent reported having cared for a patient who specifically requested a PICC. Only 25% of hospitalists reported examining PICCs for evidence of external problems, whereas 57% admitted to having, at least once, forgotten about the presence of a PICC. Only 9% of respondents knew that PICC tip verification was performed primarily to prevent venous thromboembolism. Finally, 42% of participants indicated that 10% to 25% of PICCs placed in their hospitals might be inappropriately placed and/or avoidable.

CONCLUSIONS: This national survey highlights several potential opportunities to improve hospitalist PICC practices. A research agenda dedicated to this issue is necessary to improve patient safety and hospital-based practice.

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