Objective: To create a Bedside PICC Service (BPS) to increase placement of bedside peripherally inserted central catheter (PICC) in Pediatric Intensive Care Unit (PICU) patients. Design: Two phase observational, pre-post design. Setting: Single-center quaternary non-cardiac PICU. Patients: All patients admitted to the PICU. Interventions: From June 1, 2015 to May 31, 2017 a BPS team was created (Phase I) and expanded (Phase II) as part of a quality improvement initiative. A multi-disciplinary team developed a PICC evaluation tool (PICU PET) to identify amenable patients and to suggest location and provider for procedure performance. Outcome, process and balancing metrics were evaluated. Results: BPS placed 130/493 (26%) PICC lines resulting in 2447 hospital central line days. A shift in bedside PICC centerline proportion occurred during both Phases. Median time from order to line placement was reduced for PICCs placed by BPS compared to placement in IR [6h (IQR 2h-23h) vs. 34h (IQR 19h-61h), p<0.001]. Successful access was achieved by BPS providers in 96% of patients with central tip position in 97%. BPS central line-associated blood stream infection (CLABSI) and venous thromboembolism (VTE) rates were similar to rates for PICCs placed in IR (All CLABSI 1.23 vs. 2.18, p=0.37; VTE 1.63 vs. 1.57, p=0.91). PICC lines in PICU patients had reduced VTE rate compared to PICU temporary catheter rate (1.59 vs. 5.36, p<0.001). Conclusion: BPS implementation increased bedside PICC placement and employed a patient-centered and timely process. Balancing metrics including CLABSI and VTE rates were not significantly different between PICC lines placed by BPS and those placed in IR.

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