Nurse-led PICC insertion: is it cost effective?

Walker, Graham; Todd, Alistair

doi:10.12968/bjon.2013.22.sup19.s9

Cited by 56 publications

(86 citation statements)

References 8 publications

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“…Although several innovations have helped foster such transitions, peripherally inserted central catheters (PICCs) are of particular relevance in this context for at least two reasons . First, PICC use has grown substantially because of increasing availability through hospital‐based vascular access nursing teams that offer convenient and cost‐effective bedside insertion . Second, PICCs provide durable yet nonpermanent means through which to continue long‐term intravenous treatments; thus, they serve as ideal “bridge” devices for transitions of care.…”

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confidence: 99%

Peripherally Inserted Central Catheter Use in Skilled Nursing Facilities: A Pilot Study

Chopra

Montoya

Joshi

et al. 2015

J American Geriatrics Society

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OBJECTIVES To describe patterns of use, care practices, and outcomes related to peripherally inserted central catheter (PICC) use in skilled nursing facilities (SNFs). DESIGN Prospective cohort study. SETTING Two community SNFs. PARTICIPANTS Adult SNF residents with PICCs (N = 56). MEASUREMENTS Information on indication for PICC use, device characteristics (e.g., lumens, gauge), and participant data (comorbidities, medications) were obtained from medical records. Care practices (e.g., frequency of flushing, dressing care) and problems related to PICCs were recorded. Major (central line–associated bloodstream infection, venous thromboembolism, catheter dislodgement) and minor (migration, dressing disruption, lumen occlusion, exit site infection) complications and process measures (flushing of PICC, assessment of necessity) were recorded. Bivariate analyses with t-tests, chi-square tests, or Fischer exact tests were used for continuous and categorical data. RESULTS Participants were enrolled from two SNFs. The most common indication for PICC use was intravenous antibiotic delivery. The average PICC dwell time was 43 days, and most devices were single-lumen PICCs. Major and minor complications were common and occurred in 11 (20%) and 18 (32%) participants, respectively. Occlusion (23%, n = 13), accidental dislodgement (12%, n = 7), and dressing disruption (11%, n = 6) were the commonest complications observed. Documentation regarding catheter care practices occurred in 41% of cases. CONCLUSION Quality improvement efforts that seek to benchmark practice, identify gaps, and institute efforts to improve PICC care and practice in SNFs appear necessary.

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confidence: 99%

Peripherally Inserted Central Catheter Use in Skilled Nursing Facilities: A Pilot Study

Chopra

Montoya

Joshi

et al. 2015

J American Geriatrics Society

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“…CVC tip location should be verified at the time of placement or postplacement via chest x‐ray (CXR). Many centers use intravascular electrocardiography (ECG) to confirm tip location rather than CXR, due to cost benefit and more accurate placement when compared with blind insertion 125 , 126 . In our center's experience, the ECG confirmation of PICC tip location has not been sufficiently accurate to eliminate CXR confirmation 127 .…”

Section: Pn Complicationsmentioning

confidence: 88%

Management of Parenteral Nutrition in Hospitalized Adult Patients

Mundi

Nystrom

Hurley

et al. 2016

J Parenter Enteral Nutr

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Despite the high prevalence of malnutrition in adult hospitalized patients, surveys continue to report that many clinicians are undertrained in clinical nutrition, making targeted nutrition education for clinicians essential for best patient care. Clinical practice models also continue to evolve, with more disciplines prescribing parenteral nutrition (PN) or managing the cases of patients who are receiving it, further adding to the need for proficiency in general PN skills. This tutorial focuses on the daily management of adult hospitalized patients already receiving PN and reviews the following topics: (1) PN basics, including the determination of energy and volume requirements; (2) PN macronutrient content (protein, dextrose, and intravenous fat emulsion); (3) PN micronutrient content (electrolytes, minerals, vitamins, and trace elements); (4) alteration of PN for special situations, such as obesity, hyperglycemia, hypertriglyceridemia, refeeding, and hepatic/renal disease; (5) daily monitoring and adjustment of PN formula; and (6) PN-related complications (PN-associated liver disease and catheter-related complications).

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“…A predominance of studies in the medical area is observed as, in general, doctors are responsible for the insertion of PICC. Research (33) performed to compare the cost of insertion, patient satisfaction and infection rates of PICCs inserted by trained nurses and radiologists identified a much higher expenditure when the procedure was performed by radiologists and greater patient satisfaction when performed by nurses. In addition, the results showed that the insertion by radiologists was not more successful in relation to the procedure performed by nurses, and the infection rates were higher for the catheters inserted by radiologists.…”

Section: Discussionmentioning

confidence: 99%

Cateter venoso central de inserção periférica em oncologia pediátrica: revisão de escopo

et al. 2019

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Objective: To map the scientifi c production about the use and maintenance of peripherally inserted central catheter (PICC) in children and adolescents undergoing oncology treatment. Methods: Scoping review, according to the method adapted and proposed by Levac, Colquhoun and O'Brien. Five stages were performed: identifi cation of the research question; search for relevant studies; selection of studies; extraction of the data; grouping, summarizing and presenting the results. The databases used were PubMed, CINAHL, Scopus, LILACS and Embase. Literature review articles or original articles were included, with qualitative or quantitative designs, which focused on peripherally inserted central catheters in children and adolescents, in any stage of the oncology treatment and care context, published in Portuguese, English and Spanish, between 2006 and Results: Searches in the databases returned 609 unique articles, nine of which constituted the fi nal sample. Five main themes were elaborated related to the use of the peripherally inserted central catheter: indication, insertion technique, catheter maintenance, related complications and outcomes of the use. Based on the results, the recommendations for the use of this device can be summarized, mainly related to: the treatment and type of neoplasm, selected veins, dressing types, main complications and outcomes. Conclusion: The peripherally inserted central catheter is a safe and reliable option for intravenous therapy in the pediatric oncology population. This study contributes to evidence the indication of its use for that population and appoints themes for future empirical studies. ResumoObjetivo: Conhecer a produção científi ca sobre a utilização e manutenção do cateter central de inserção periférica (CCIP) em crianças e adolescentes em tratamento oncológico. Métodos: Revisão do tipo Scoping Review, segundo o método adaptado e proposto por Levac, Colquhoun e O'Brien. Foram percorridas cinco etapas: identifi cação da questão de pesquisa; buscas por estudos relevantes; seleção de estudos; extração dos dados; agrupamento, resumo e apresentação dos resultados. Utilizaram-se as bases de dados PubMed, CINAHL, Scopus, LILACS e Embase. Foram incluídos artigos de revisão da literatura ou originais, de abordagem quantitativa ou qualitativa, que focalizassem o cateter venoso central de inserção periférica em crianças e adolescentes com câncer, em qualquer fase do tratamento oncológico e contexto de cuidado, publicados em português, ing lês e espanhol, no período de 2006 a 2017. Resultados: Buscas nas bases de dados capturaram 609 artigos únicos, dos quais nove compuseram a amostra fi nal. Foram elaborados cinco temas principais relacionados à utilização do cateter venoso central de inserção periférica: indicação, técnica de inserção, manutenção do cateter, complicações relacionadas e desfechos do uso. Os resultados permitem sintetizar as recomendações para a utilização deste dispositivo no que se refere, sobretudo, a: terapêutica e tipo de neoplasia, veias de escolhas, tipos d...

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Nurse-led PICC insertion: is it cost effective?

Abstract: The authors conclude that the majority of PICCs can be safely performed without x-ray screening in a ward-based environment. This is likely to be the most cost-effective solution for large volume services.

Cited by 56 publications

References 8 publications

Peripherally Inserted Central Catheter Use in Skilled Nursing Facilities: A Pilot Study

Peripherally Inserted Central Catheter Use in Skilled Nursing Facilities: A Pilot Study

Management of Parenteral Nutrition in Hospitalized Adult Patients

Cateter venoso central de inserção periférica em oncologia pediátrica: revisão de escopo

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