Table 2.
Outcomes and Evaluations Associated with Use of PICCs in SNFs
| PICC N=56 | |
|---|---|
| Medical Chart Review | |
|
| |
| Flushing protocol in place | 50 (89%) |
| If present, adherence to flushing protocol | 46 (82%) |
| Assessment of line necessity by nurse or physiciana | 41 (73%) |
| Lack of ongoing PICC useb | 39 (70%) |
| PICC site evaluations | 23 (41%) |
| Lumen occlusion | 13 (23%) |
| Accidental removal or dislodgement | 7 (12%) |
| Dressing disruption | 6 (11%) |
| Migration | 3 (5%) |
| CLABSI | 1 (2%) |
| Exit-site infection | 1 (2%) |
|
| |
| Informal Interviews | |
|
| |
| Patient-reported PICC problemsc | 26 (46%) |
| Nurse-reported PICC problemsd | 14 (25%) |
| Additional reviewer-noted PICC problemse | 11 (20%) |
|
| |
| PICC appropriateness [in reviewer’s opinion]f | 42 (75%) |
CLABSI=central line-associated bloodstream infection; PICC=peripherally inserted central catheter
Assessment refers to the presence of documentation in the chart that indicated that the PICC in question was clinically in use or still clinically necessary. We have added this to a footnote in the table
Lack of ongoing PICC use was defined as no use of the PICC for at least 7 days or between 2 weekly visits
Patient-reported PICC problems include difficulty using the arm where catheter was inserted for daily activities, arm swelling, pain, redness, tenderness, itching/irritation, crusting at exit site, occlusion, migration, dislodgment, dressing concerns, inability to flush PICC or inability to use PICC
Nurse-reported PICC complications include trouble using catheter, migration at exit site, inability to flush PICC or inability to use PICC
Additional PICC complications observed by reviewer upon examination of PICC site that were not documented included arm swelling, redness over PICC entry site and dressing disruption (wet, soiled, loose)
PICCs were considered inappropriate if they had not been used for > 1 week or if they were removed within a week of insertion.