miércoles, 28 de septiembre de 2016

Peripherally Inserted Central Catheter Use in Skilled Nursing Facilities: A Pilot Study. - PubMed - NCBI

Peripherally Inserted Central Catheter Use in Skilled Nursing Facilities: A Pilot Study. - PubMed - NCBI



 2015 Sep;63(9):1894-9. doi: 10.1111/jgs.13600. Epub 2015 Aug 27.

Peripherally Inserted Central Catheter Use in Skilled Nursing Facilities: A Pilot Study.

Chopra V1,2Montoya A3,4Joshi D3,4Becker C1Brant A1McGuirk H1,2Clark J1Harrod M1Kuhn L1,2Mody L3,4.

Abstract

OBJECTIVES:

To describe patterns of use, care practices, and outcomes related to peripherally inserted central catheter (PICC) use in skilled nursing facilities (SNFs).

DESIGN:

Prospective cohort study.

SETTING:

Two community SNFs.

PARTICIPANTS:

Adult SNF residents with PICCs (N = 56).

MEASUREMENTS:

Information on indication for PICC use, device characteristics (e.g., lumens, gauge), and participant data (comorbidities, medications) were obtained from medical records. Care practices (e.g., frequency of flushing, dressing care) and problems related to PICCs were recorded. Major (central line-associated bloodstream infection, venous thromboembolism, catheter dislodgement) and minor (migration, dressing disruption, lumen occlusion, exit site infection) complications and process measures (flushing of PICC, assessment of necessity) were recorded. Bivariate analyses with t-tests, chi-square tests, or Fischer exact tests were used for continuous and categorical data.

RESULTS:

Participants were enrolled from two SNFs. The most common indication for PICC use was intravenous antibiotic delivery. The average PICC dwell time was 43 days, and most devices were single-lumen PICCs. Major and minor complications were common and occurred in 11 (20%) and 18 (32%) participants, respectively. Occlusion (23%, n = 13), accidental dislodgement (12%, n = 7), and dressing disruption (11%, n = 6) were the commonest complications observed. Documentation regarding catheter care practices occurred in 41% of cases.

CONCLUSION:

Quality improvement efforts that seek to benchmark practice, identify gaps, and institute efforts to improve PICC care and practice in SNFs appear necessary.
© 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

KEYWORDS:

central line-associated bloodstream infection; deep vein thrombosis; peripherally inserted central catheter; skilled nursing facility; venous thromboembolism

PMID:
 
26312402
 
PMCID:
 
PMC4626207
 
DOI:
 
10.1111/jgs.13600

[PubMed - indexed for MEDLINE] 
Free PMC Article

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