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Reducing peripherally inserted central catheters in the neonatal intensive care unit

Journal of Perinatology volume 37, pages 409–413 (2017)Cite this article

Subjects

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.

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Acknowledgements

We thank Ms Gina Myers, RN and Amy Distler, RN for providing support for the project.

Author contributions

AJV conceptualized and designed the study, drafted the initial manuscript, carried out the analysis and approved the final manuscript as submitted. AE and AMM reviewed and revised the manuscript, and approved the final manuscript as submitted. NAV designed the data collection instruments, critically reviewed the manuscript and approved the final manuscript as submitted. HM collected data, analyzed the data, critically reviewed the manuscript and approved the final manuscript as submitted. AN collected and analyzed the data, critically reviewed the manuscript and approved the final manuscript as submitted. DAL helped collect the data, critically reviewed the manuscript and approved the final manuscript as submitted.

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Authors and Affiliations

  1. Department of Pediatrics, Washington University in St. Louis, St. Louis, MO, USA

    A J Vachharajani, A Elward & A M Mathur

  2. Department of Surgery, Washington University in St. Louis, St. Louis, MO, USA

    N A Vachharajani

  3. St Louis Children’s Hospital, St. Louis, MO, USA

    H Morris, A Niesen & D A Linck

Authors
  1. A J Vachharajani
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  2. N A Vachharajani
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  3. H Morris
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  4. A Niesen
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  5. A Elward
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  6. D A Linck
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  7. A M Mathur
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Corresponding author

Correspondence to A J Vachharajani.

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The authors declare no conflict of interest.

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Supplementary Information accompanies the paper on the Journal of Perinatology website

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Vachharajani, A., Vachharajani, N., Morris, H. et al. Reducing peripherally inserted central catheters in the neonatal intensive care unit. J Perinatol 37, 409–413 (2017). https://doi.org/10.1038/jp.2016.243

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  • DOI: https://doi.org/10.1038/jp.2016.243

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