Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-25T01:43:06.060Z Has data issue: false hasContentIssue false

A quality improvement project to decrease utilization of multilumen peripherally inserted central catheters

Published online by Cambridge University Press:  25 September 2020

Jennifer Kleinman Sween*
Affiliation:
Division of Hospital Internal Medicine, Mayo Clinic, Rochester, Minnesota
Angela Lowrie
Affiliation:
Department of Nursing, Mayo Clinic, Rochester, Minnesota
Jane M. Kirmse
Affiliation:
Department of Nursing, Mayo Clinic, Rochester, Minnesota
Rena Kane Laughlin
Affiliation:
Division of Hospital Internal Medicine, Mayo Clinic, Rochester, Minnesota
Brooke Wodziak
Affiliation:
Office of Education Project Management, Mayo Clinic, Rochester, Minnesota
Priya Sampathkumar
Affiliation:
Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota
*
Author for correspondence: Jennifer Kleinman Sween, MD, E-mail: [email protected].

Abstract

We performed a quality improvement project to decrease utilization of multilumen peripherally inserted central catheters (PICCs) in favor of single-lumen PICCs and midline catheters. Through optimization of electronic orders, education and decision support, we decreased utilization of multilumen PICCs, changed provider ordering patterns, and showed a downward trend in CLABSIs.

Type
Concise Communication
Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

PREVIOUS PRESENTATION. Portions of this quality improvement work were presented at a poster session at the annual meeting of the Society of Hospital Medicine on March 25, 2019, in National Harbor, Maryland, and at the Institute for Healthcare Improvement National Forum on December 11, 2018, in Orlando, Florida. The abstract was accepted for poster presentation at the SHEA/CDC Decennial Meeting, ultimately, however, it was not presented due to the cancellation of the meeting.

References

Alexandrou, E, Spencer, TR, Frost, SA, Mifflin, N, Davidson, PM, Hillman, KM. Central venous catheter placement by advanced practice nurses demonstrates low procedural complication and infection rates: a report from 13 years of service. Crit Care Med 2014;42:536543.CrossRefGoogle Scholar
Chopra, V, O’Horo, JC, Rogers, MA, Maki, DG, Safdar, N. The risk of bloodstream infection associated with peripherally inserted central catheters compared with central venous catheters in adults: a systematic review and meta-analysis. Infect Control Hosp Epidemiol 2013;34:908918.CrossRefGoogle ScholarPubMed
Chopra, V, Anand, S, Krein, SL, Chenoweth, C, Saint, S. Bloodstream infection, venous thrombosis, and peripherally inserted central catheters: reappraising the evidence. Am J Med 2012;125:733741.CrossRefGoogle ScholarPubMed
Chopra, V, Ratz, D, Kuhn, L, Lopus, T, Chenoweth, C, Krein, S. PICC-associated bloodstream infections: prevalence, patterns, and predictors. Am J Med 2014;127:319328.CrossRefGoogle ScholarPubMed
Chopra, V, Anand, S, Hickner, A, et al. Risk of venous thromboembolism associated with peripherally inserted central catheters: a systematic review and meta-analysis. Lancet 2013;382:311325.CrossRefGoogle ScholarPubMed
Herc, E, Patel, P, Washer, LL, Conlon, A, Flanders, SA, Chopra, V. A model to predict central-line–associated bloodstream infection among patients with peripherally inserted central catheters: the MPC score. Infect Control Hosp Epidemiol 2017;38:11551166.CrossRefGoogle Scholar
Chopra, V, Flanders, SA, Saint, S, et al. The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC): results from a multispecialty panel using the RAND/UCLA appropriateness method. Ann Intern Med 2015;163 suppl 6:S1S40.Google ScholarPubMed
Bozaan, D, Skicki, D, Brancaccio, A, et al. Less lumens-less risk: a pilot intervention to increase the use of single-lumen peripherally inserted central catheters. J Hosp Med 2019;14:4246.CrossRefGoogle ScholarPubMed
Swaminathan, L, Flanders, S, Rogers, M, et al. Improving PICC use and outcomes in hospitalised patients: an interrupted time series study using MAGIC criteria. BMJ Qual Saf 2018;27:271278.CrossRefGoogle ScholarPubMed