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- Title
Implementation of a Quality Improvement Initiative Reduces PICC Migrations in a Complex Continuing Care Hospital.
- Authors
Djurcic-Jovan, Ankica; Eisener, Alexandra; McDiarmid, Sheryl; Jewell, Andrea
- Abstract
Problem/Purpose: A Complex Continuing Care Hospital noted a large number of Peripherally Inserted Central Catheter (PICC) migrations, and noncompliance to best practices resulting in potential patient harm, delays in infusion therapy, and unnecessary healthcare costs. Approach: To address PICC migration and care, a Force Field Analysis tool was used to assess barriers and facilitators for change resulting in strategies for improvement. These included: (1) Collaboration with an acute care hospital to develop guidelines to reduce PICC migration based on best practices (2) Insertion of a stabilization device at time of insertion that remains in situ throughout the dwell time of the catheter (3) Clinician education based on best practice recommendations (4) Ensuring physicians and nurses adhere to hospital policy for suspected catheter migration. Evaluation strategies were employed throughout the project. Results: A significant decrease in PICC migrations reduced reinsertions resulting in cost savings. Preimplementation data indicates a total of 56 reinsertions from January 2014-15; whereas, post-implementation data shows only 3 reinsertions from February to September 2015. An estimated $9010 of savings is noted on patient transportation to acute care PICC clinic alone. There has been no documented external migration on patients with the permanent PICC securement device in situ. Soft savings were revealed through reduction of clinician time coordinating care and ease of manipulating PICC during care and maintenance. Conclusion: This collaborative quality improvement initiative between regional partners has reduced PICC migration resulting in enhanced patient and provider satisfaction, improved patient outcomes with a decrease cost to the health care system. How topic incorporates conference theme: The project’s benefits are demonstrated through the continued delivery of infusion therapy, prevention of CVAD complications, and the reduction of catheter dislodgements and migration.
- Subjects
CATHETERIZATION complications; FOREIGN body migration; LEGAL compliance; HEALTH facility administration; INTERPROFESSIONAL relations; EVALUATION of medical care; NURSES; PROFESSIONS; QUALITY assurance; PERIPHERALLY inserted central catheters; PREVENTION
- Publication
Vascular Access, 2016, Vol 10, Issue 2, p7
- ISSN
1913-6692
- Publication type
Article