DO USERS OF TECHNOLOGY DIFFER FROM NON-USERS IN PERIPHERALLY INSERTED CENTRAL CATHETER PRACTICE? AN ANALYSIS OF THE PICC1 SURVEY

Vineet Chopra, MD, MSc1;Latoya Kuhn, MPH2;David Ratz, MS2;Suzanne Winter, MS3;Peter Carr, PhD4;Dr. David Paje, MD, MPH*1,3 and Dr. Sarah Krein, PhD5, (1)VA Ann Arbor Healthcare System, Ann Arbor, MI, (2)The Patient Safety Enhancement Program, University of Michigan and VA Ann Arbor Health System, Ann Arbor, MI, (3)University of Michigan Health System, Ann Arbor, MI, (4)The University of Western Australia, Crawley, Perth, Australia, (5)University of Michigan, Ann Arbor, MI

Meeting: Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.

Abstract number: 120

Categories: Patient Safety, Research Abstracts

Keywords: , , ,

Background: While use of technologies such as ultrasound and electrocardiographic (EKG) guidance systems to place peripherally inserted central catheters (PICCs) has grown, little is known about the setting, experience or practice of providers that use these tools.

Methods: Using data from the PICC1 survey of vascular access specialists, we identified technology-users from non-users. We defined technology-users as those that: (a) use ultrasound to find a suitable vein for catheter placement; (b) measure the catheter-to-vein ratio and; (c) use EKG for PICC placement. Responses for technology-users were compared to non-users. Bivariable comparisons were made using Chi-squared tests; two-sided alpha with p<0.05 was considered statistically significant.

Results: Of the 2762 PICC inserters who accessed the survey, 1518 (55%) provided information regarding technology use. Technology-users were more likely to be part of vascular access teams with >10 members compared to non-technology users (35% vs. 22%, p<0.001). Compared to non-technology users, technology-users had greater experience, as more reported having placed >1000 PICCs (55% vs. 45%, p<0.001). Practice patterns for insertion and care of PICCs varied between the groups. For example, a greater proportion of technology-users reported receiving assistance from another vascular access nurse during PICC placement (55% vs. 44%, p<0.001). Technology-users more often used a “targeted” flushing strategy (flushing lumens that were not being actively used) whereaas non-technology users reported flushing all lumens daily regardless of use (30% vs. 21%, p<0.001). Technology-users were more likely to report tracking dwell time of PICCs (67% vs. 28%, p=0.001) and more frequently reported the ability to remove PICCs that were clinically not indicated than non-technology users (29% vs. 17%, p<0.001). Placement of PICCs for inappropriate reasons were more often reported by technology users than non-users (46% vs. 35%, p<0.001).

Conclusions: Technology use among vascular access nursing is associated with important differences in work setting and practice. Better understanding whether such differences influence outcomes appears necessary.

To cite this abstract:

Chopra, V; Kuhn, L; Ratz, D; Winter, S; Carr, P; Paje, D; Krein, S . DO USERS OF TECHNOLOGY DIFFER FROM NON-USERS IN PERIPHERALLY INSERTED CENTRAL CATHETER PRACTICE? AN ANALYSIS OF THE PICC1 SURVEY. Abstract published at Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev. Abstract 120. Journal of Hospital Medicine. 2017; 12 (suppl 2). https://www.shmabstracts.com/abstract/do-users-of-technology-differ-from-non-users-in-peripherally-inserted-central-catheter-practice-an-analysis-of-the-picc1-survey/. Accessed September 18, 2019.

« Back to Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.