Methods: Using data from the PICC1 survey of vascular access specialists, we identified technology-users from non-users. We defined technology-users as those that: (a) use ultrasound to find a suitable vein for catheter placement; (b) measure the catheter-to-vein ratio and; (c) use EKG for PICC placement. Responses for technology-users were compared to non-users. Bivariable comparisons were made using Chi-squared tests; two-sided alpha with p<0.05 was considered statistically significant.
Results: Of the 2762 PICC inserters who accessed the survey, 1518 (55%) provided information regarding technology use. Technology-users were more likely to be part of vascular access teams with >10 members compared to non-technology users (35% vs. 22%, p<0.001). Compared to non-technology users, technology-users had greater experience, as more reported having placed >1000 PICCs (55% vs. 45%, p<0.001). Practice patterns for insertion and care of PICCs varied between the groups. For example, a greater proportion of technology-users reported receiving assistance from another vascular access nurse during PICC placement (55% vs. 44%, p<0.001). Technology-users more often used a “targeted” flushing strategy (flushing lumens that were not being actively used) whereaas non-technology users reported flushing all lumens daily regardless of use (30% vs. 21%, p<0.001). Technology-users were more likely to report tracking dwell time of PICCs (67% vs. 28%, p=0.001) and more frequently reported the ability to remove PICCs that were clinically not indicated than non-technology users (29% vs. 17%, p<0.001). Placement of PICCs for inappropriate reasons were more often reported by technology users than non-users (46% vs. 35%, p<0.001).
Conclusions: Technology use among vascular access nursing is associated with important differences in work setting and practice. Better understanding whether such differences influence outcomes appears necessary.