A 6-Month Study of the Rate of Infections and Complications in Patients with Peripherally-Inserted Central Catheters

BACKGROUND/OBJECTIVES: Peripherally inserted central catheters (PICCs) are intravenous catheters placed for long-, medium-, and short-term use. PICCs are used for drug and fluid administration, blood sampling, dialysis, and hyperalimentation. Ochsnerʹs Interventional Radiology Service place an estimated one thousand PICCs annually with success. With the increased use of PICCs in the clinical community, medical institutions, with limited experience, have reported complications. To this end, we report the technical success and failures of our procedures which include infection control measures such as chlorahexidine skin antisepsis, hand hygiene, and barrier precautions. METHODS: A multidisciplinary team designed the tool used to collect data for this study. Team members included Infection Control, Infectious Diseases physicians, Interventional Radiology physicians and nurses, Home Health, Chemotherapy Infusion nurses, and Heart Transplant services nurses. The tool was set up to capture 100% of patients in real time who received a PICC introduced by Interventional Radiology during a 6-month period (January 1-June 30, 2005). The data collected included: patient name, clinic number, ordering physician, reason for PICC, PICC insertion date, primary operator, review radiologist, PICC type, date PICC discontinued, complications, nursing unit, culture results, Home Health agency upon discharge, readmit date, and comments. RESULTS: Five hundred patients were included in this study. PICCs were placed for antibiotic therapy (44%), total parenteral nutrition (21%), general IV access (14%), cardiac medications (11%), chemotherapy (8.4%), and blood transfusions (0.2%). The average dwell time was 14.7days (range 1 to 125 days) for patients with known PICC discharge date. Infection Control was able to identify four patients (0.8%) who developed an infection. 99.2% of patients with PICCs placed by Interventional Radiology did not report infection. CONCLUSIONS: This Infection Control driven PICC study was a useful quality improvement project for infection risk assessment. Infection Control measures and catheter care education are important for PICC success.