Neonatal intensive care units (NICUs) commonly utilize peripherally inserted central catheters (PICCs) to provide nutrition and long-term medications to premature and full-term infants. However, little is known about PICC practices in these settings.
To assess PICC practices, policies, and providers in NICUs.
The Neonatal PICC1 Survey was conducted through the use of the electronic mailing list of a national neonatal professional organization's electronic membership community. Questions addressed PICC-related policies, monitoring, practices, and providers. Descriptive statistics were used to assess results.
Of the 156 respondents accessing the survey, 115 (73.7%) indicated that they placed PICCs as part of their daily occupation. Of these, 110 responded to at least one question (70.5%) and were included in the study. Reported use of evidence-based practices by NICU providers varied. For example, routine use of maximum sterile barriers was reported by 90.4% of respondents; however, the use of chlorhexidine gluconate for skin disinfection was reported only by 49.4% of respondents. A majority of respondents indicated that trained PICC nurses were largely responsible for routine PICC dressing changes (61.0%). Normal saline was reported as the most frequently used flushing solution (46.3%). The most common PICC-related complications in neonates were catheter migration and occlusion.
Variable practices, including the use of chlorhexidine-based solutions for skin disinfection and inconsistent flushing, exist. There is a need for development of consistent monitoring to improve patient outcomes.
Future research should include exploration of specific PICC practices, associated conditions, and outcomes.
The School of Nursing, University of Alabama at Birmingham (Dr Sharpe); The Division of General Medicine, University of Michigan Health System, Ann Arbor (Drs Krein and Chopra); and Center for Clinical Management Research and Patient Safety Enhancement Program, VA Ann Arbor Healthcare System, Ann Arbor, Michigan (Ms Kuhn, Mr Ratz, and Drs Krein and Chopra).
Correspondence: Elizabeth Sharpe, DNP, APRN, NNP-BC, VA-BC, University of Alabama at Birmingham School of Nursing, NB406, 1720 2nd Ave South, Birmingham, AL 35294 (email@example.com).
Elizabeth Sharpe is a speaker for Argon Medical Devices and Salveo Healthcare, has consulted for C. R. Bard, and is on the Advisory Board for IV Watch. No conflicts of interest are declared for all coauthors.