Reducing the number of peripherally inserted central catheters inserted in infants

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Our objective was to safely reduce the number of peripherally inserted central catheters (PICCs) inserted in infants with umbilical venous catheter using quality improvement methods” Vachharajani et al (2017).

Abstract:

OBJECTIVE: Our objective was to safely reduce the number of peripherally inserted central catheters (PICCs) inserted in infants with umbilical venous catheter using quality improvement methods.

STUDY DESIGN: In a tertiary neonatal intensive care unit, a questionnaire designed to prompt critical thinking around the decision to place a PICC, along with an updated standardized feeding guideline was introduced. PICC insertion in 86 infants with umbilical venous catheter (pre intervention) with birth weight 1000-1500 g were compared with 115 infants (post intervention) using Fisher’s exact test.

RESULTS: PICC lines inserted after the intervention decreased by 37.5% (67/86; 77.9% vs 56/115; 48.7%; P<0.001). The proportion of central line-associated blood stream infection were 2.49 vs 2.82/1000 umbilical venous catheter days; P=0.91 in the two epochs, respectively.

CONCLUSION: Quality improvement methodology was successful in significantly reducing the number of PICCs inserted without an increase in central line-associated blood stream infection.

Reference:

Vachharajani, A.J., Vachharajani, N.A., Morris, H., Niesen, A., Elward, A., Linck, D.A. and Mathur, A.M. (2017) Reducing peripherally inserted central catheters in the neonatal intensive care unit. Journal of Perinatology. January 12th. [Epub ahead of print].

doi: 10.1038/jp.2016.243.

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