Journal article
Inappropriate Use of Peripherally Inserted Central Catheters in Pediatrics: A Multisite Study
Hospital pediatrics, Vol.14(3), pp.180-188
03/01/2024
DOI: 10.1542/hpeds.2023-007518
PMCID: PMC10896745
PMID: 38404202
Abstract
OBJECTIVES
This study aimed to describe how the current practice of peripherally inserted central catheter (PICC) use in hospitalized children aligns with the Michigan Appropriateness Guide for Intravenous Catheters (miniMAGIC) in Children recommendations, explore variation across sites, and describe the population of children who do not receive appropriate PICCs.
METHODS
A retrospective study was conducted at 4 children’s hospitals in the United States. Children with PICCs placed January 2019 to December 2021 were included. Patients in the NICU were excluded. PICCs were categorized using the miniMAGIC in Children classification as inappropriate, uncertain appropriateness and appropriate.
RESULTS
Of the 6051 PICCs identified, 9% (n = 550) were categorized as inappropriate, 9% (n = 550) as uncertain appropriateness, and 82% (n = 4951) as appropriate. The number of PICCs trended down over time, but up to 20% of PICCs each year were not appropriate, with significant variation between sites. Within inappropriate or uncertain appropriateness PICCs (n = 1100 PICC in 1079 children), median (interquartile range) patient age was 4 (0–11) years, 54% were male, and the main reason for PICC placement was prolonged antibiotic course (56%, n = 611). The most common admitting services requesting the inappropriate/uncertain appropriateness PICCs were critical care 24%, general pediatrics 22%, and pulmonary 20%. Complications resulting in PICC removal were identified in 6% (n = 70) of inappropriate/uncertain PICCs. The most common complications were dislodgement (3%) and occlusion (2%), with infection and thrombosis rates of 1% (n = 10 and n = 13, respectively).
CONCLUSIONS
Although the majority of PICCs met appropriateness criteria, a substantial proportion of PICCs were deemed inappropriate or of uncertain appropriateness, illustrating an opportunity for quality improvement.
Details
- Title: Subtitle
- Inappropriate Use of Peripherally Inserted Central Catheters in Pediatrics: A Multisite Study
- Creators
- Alina G. Burek - Children's Hospital of WisconsinMary Beth Davis - University of IowaBrittany Pechous - University of Iowa Stead Family Children’s HospitalErin E. Shaughnessy - University of Alabama at BirminghamKatie A. Meier - Cincinnati Children's Hospital Medical CenterSarah Mooney - Children's Hospital of WisconsinDana Woodruff - University of Alabama at BirminghamMeaghan Bruner - University of Alabama at BirminghamLaura Piper - Cincinnati Children's Hospital Medical CenterMelodee Liegl - Medical College of WisconsinAmy Pan - Medical College of WisconsinDavid C. Brousseau - Thomas Jefferson UniversityAmanda J. Ullman - The University of Queensland
- Resource Type
- Journal article
- Publication Details
- Hospital pediatrics, Vol.14(3), pp.180-188
- DOI
- 10.1542/hpeds.2023-007518
- PMID
- 38404202
- PMCID
- PMC10896745
- NLM abbreviation
- Hosp Pediatr
- ISSN
- 2154-1663
- eISSN
- 2154-1671
- Number of pages
- 9
- Grant note
- Becton Dickinson 3M (http://data.elsevier.com/vocabulary/SciValFunders/100004343) National Institutes of Health (http://data.elsevier.com/vocabulary/SciValFunders/100000002) CSL Behring (http://data.elsevier.com/vocabulary/SciValFunders/100008322) UL1 TR001436 / National Institutes of Health (http://data.elsevier.com/vocabulary/SciValFunders/100000002) University of Queensland (http://data.elsevier.com/vocabulary/SciValFunders/501100001794)
- Language
- English
- Date published
- 03/01/2024
- Academic Unit
- Nursing
- Record Identifier
- 9985219855702771
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