National Association of Neonatal Nurses PICC guidelines
Abstract:
Background and significance: The National Association of Neonatal Nurses (NANN) has been a forerunner in its commitment to recognizing the importance of consistent care of peripherally inserted central catheters (PICCs) in neonates as essential for maintenance of their lifelines. NANN has published the only guideline that focuses on PICC practices specific to neonates and infants since its first guideline in 2001. The Peripherally Inserted Central Catheters: Guideline for Practice, 4th edition, follows in this tradition as an updated clinical resource directed to nurses, nurse practitioners, physicians, physician associates, and others who may care for infants with vascular access requirements. This fourth edition highlights the most recent literature informing evidence-based best practices to support care of neonates and infants who may require a PICC at birth or in the future. Beginning early vascular access assessment and planning at birth promotes vessel preservation across the lifespan.
New to this fourth edition:
Key components of this guideline include updated recommendations, neonatal PICC insertion procedures, discussion of insertion-related complications and interventional strategies, monitoring for post-insertion complications, care, maintenance, and current perspectives on emerging new technologies such as ultrasound and catheter securement. This fourth edition includes updates throughout the document supported by 280 references, with over 70% new since the third edition, with 11 images.1
The fourth edition of the guideline presents a concerted approach to harm prevention focusing on monitoring for early complications detection and management with increased emphasis on collaborative interprofessional PICC teams.
The summary of recommendations leads with the definitive critically important key recommendation for appropriate catheter tip location in the superior vena cava through upper body insertion sites and the inferior vena cava through lower body insertion sites to minimize risks of complications. Additional recommendations address repositioning, antiseptics, dressings, education, and technology.
Conclusion: The NANN PICC Guideline has served as a respected resource for vascular access protocol development in neonatal intensive care units around the world. This most recent edition continues as the foundational resource for protocols, policies, and procedures development for nurses and other clinicians inserting PICCs and managing neonates and infants with PICCs around the world. The NANN recommends that this guideline be considered an essential resource in the development of education and training for any clinician performing PICC insertion, care, monitoring, and management. A consistent interprofessional approach is critical to influence future positive outcomes for our tiny patients.
Reference:
Sharpe EL, Curry S, Wyckoff MM. NANN Neonatal Peripherally Inserted Central Catheters: Guideline for Practice, 4th ed. Adv Neonatal Care. 2024 Aug 1;24(4):313-315. doi: 10.1097/ANC.0000000000001182. Epub 2024 Jul 24. PMID: 39052577.