Background: The position of the tip of a peripherally inserted central catheter (PICC) is associated with deep vein thrombosis (DVT). Optimal position of the tip is the cavoatrial junction; more proximal tip positions are associated with greater risk of DVT. EKG-guidance has recently emerged as a modality to ensure proper tip position. Compared to chest [...]

Background: Peripherally inserted central catheters (PICCs) are routinely placed in hospitalized patients who are receiving long-term IV antibiotics or who have poor venous access. In our hospital, 1 in 12 patients on the Medicine service receives a PICC line at some point during a hospitalization. 35% of all hospital-acquired venous thromboembolisms (VTEs) on the Medicine [...]

Background: The University of Colorado Hospital (UCH) fails to meet the National Healthcare Safety Network (NHSN) benchmarks for central line utilization rates and central line-associated bloodstream infections (CLABSI). Peripherally inserted central catheters (PICCs) are central lines that are overused and misused at UCH. Overuse of PICC lines increases the risks of CLABSI and PICC-associated deep [...]

Background: Vascular access is an integral part of inpatient care. Difficult access can result in delays and inappropriate access selection or technical placement can have quality and financial implications, particularly those associated with catheter-line associated blood stream infections (CLABSI). At our institution, vascular access had historically been provider driven resulting in non-standardized selection practices with [...]

Background: Peripherally inserted central catheters (PICCs) are increasingly used for vascular access in hospitalized patients due to convenience and long term viability. PICC lines are known to have complications such as deep venous thromboses and central line associated bloodstream infections (CLABSI). According to the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC), there are few appropriate [...]