PICC line practices in neonatal intensive care units

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Neonatal intensive care units (NICUs) commonly utilize peripherally inserted central catheters (PICCs) to provide nutrition and long-term medications to premature and full-term infants. However, little is known about PICC practices in these settings” Sharpe et al (2016).

Abstract:

BACKGROUND: Neonatal intensive care units (NICUs) commonly utilize peripherally inserted central catheters (PICCs) to provide nutrition and long-term medications to premature and full-term infants. However, little is known about PICC practices in these settings.

PURPOSE: To assess PICC practices, policies, and providers in NICUs.

METHODS: The Neonatal PICC1 Survey was conducted through the use of the electronic mailing list of a national neonatal professional organization’s electronic membership community. Questions addressed PICC-related policies, monitoring, practices, and providers. Descriptive statistics were used to assess results.

RESULTS: Of the 156 respondents accessing the survey, 115 (73.7%) indicated that they placed PICCs as part of their daily occupation. Of these, 110 responded to at least one question (70.5%) and were included in the study. Reported use of evidence-based practices by NICU providers varied. For example, routine use of maximum sterile barriers was reported by 90.4% of respondents; however, the use of chlorhexidine gluconate for skin disinfection was reported only by 49.4% of respondents. A majority of respondents indicated that trained PICC nurses were largely responsible for routine PICC dressing changes (61.0%). Normal saline was reported as the most frequently used flushing solution (46.3%). The most common PICC-related complications in neonates were catheter migration and occlusion.

IMPLICATIONS FOR PRACTICE: Variable practices, including the use of chlorhexidine-based solutions for skin disinfection and inconsistent flushing, exist. There is a need for development of consistent monitoring to improve patient outcomes.

IMPLICATIONS FOR RESEARCH: Future research should include exploration of specific PICC practices, associated conditions, and outcomes.

Reference:

Sharpe, E., Kuhn, L., Ratz, D., Krein, S.L. and Chopra, V. (2016) Neonatal Peripherally Inserted Central Catheter Practices and Providers: Results From the Neonatal PICC1 Survey. Advances in Neonatal Care. December 29th. [Epub ahead of print].

doi: 10.1097/ANC.0000000000000376.

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