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- Title
A Multifocal Approach to Quality Care of Peripherally Inserted Central Catheters in a Rehabilitation and Complex Continuing Care Facility.
- Authors
Penney, Jennifer; McNamee, Jane
- Abstract
Our centre is a Rehabilitation and Complex Continuing Care facility, designated as a Registered Nurses Association of Ontario (RNAO) Best Practice Spotlight Organization (BPSO®). The centre is committed to advancing and sustaining evidence-informed practice. A regular review of our peripherally inserted central catheter (PICC) policy revealed inconsistencies between our practices and the current evidence, particularly in regards to the assessment and management of PICC occlusions. Through a multifocal quality improvement approach, we aimed to promote the strongest evidence-informed CVAD practices possible by creating an exemplary PICC policy, as well as transitioning our PICC documentation from paper-based to the electronic patient record (EPR). Our approach involved (1) a review of best practice literature, (2) consultation with CVAD experts, (3) development of a new policy to manage PICC occlusions using alteplase, (4) the design and build of a PICC treatment administration record (TAR) for the EPR, and (5) point-of-ofcare teaching to ensure the sustained uptake of new PICC care and documentation practices. Although fraught with the proverbial ups and downs of change management, our persistent and systematic improvement efforts have resulted in a number of successes including (1) enhanced assessment of PICC patency, (2) reduction in patient transfers to acute care facilities to manage PICC occlusions, and (3) standardized documentation processes that support improved PICC practices. Conference participants will benefit from learning about our quality improvement processes from identifying the issues through to achievement of excellence in PICC practices underpinned by the full engagement of both informal and formal leaders within the organization.
- Subjects
CONTINUUM of care; MEDICAL quality control; QUALITY assurance; REHABILITATION centers; PERIPHERAL central venous catheterization; PERIPHERALLY inserted central catheters; ELECTRONIC health records
- Publication
Vascular Access, 2014, Vol 8, Issue 1, p22
- ISSN
1913-6692
- Publication type
Article