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Neonatal Peripherally Inserted Central Catheter Practices and Providers: Results From the Neonatal PICC1 Survey.

Sharpe E, Kuhn L, Ratz D, Krein SL, Chopra V. Neonatal Peripherally Inserted Central Catheter Practices and Providers: Results From the Neonatal PICC1 Survey. Advances in neonatal care : official journal of the National Association of Neonatal Nurses. 2017 Jun 1; 17(3):209-221.

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Abstract:

BACKGROUND: 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. PURPOSE: To assess PICC practices, policies, and providers in NICUs. METHODS: 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. 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. IMPLICATIONS FOR PRACTICE: 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. IMPLICATIONS FOR RESEARCH: Future research should include exploration of specific PICC practices, associated conditions, and outcomes.





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