Background: We have previously showed how implementing the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) to inform peripherally inserted central catheter (PICC) use can lead to more appropriate device use. In this analysis, we assessed the association between appropriateness and PICC-related complications. We hypothesized that improved PICC appropriateness is associated with reduced major PICC complications […]

Background: Patients with cancer require reliable venous access for therapy. Although peripherally inserted central catheters (PICCs) and implanted ports are often used to meet infusion needs, risk of complications between these devices is unknown. We did a systematic review and meta-analysis to compare the risk of deep vein thrombosis (DVT), exit-site complications and central line-associated […]

Background: Central line-associated bloodstream infection (CLABSI) is a morbid and potentially lethal complication. National policies related to CLABSI mandate public reporting of this adverse event, with hospitals receiving penalties based on their CLABSI rates. Contemporary data suggest that peripherally inserted central catheters (PICCs) placed outside critical care settings are a large contributor to hospital CLABSI […]

Background: Altered mental status (AMS) is prevalent in hospitalized patients, especially the elderly (1). The work up of AMS is based on history, physical exam, pertinent labs and imaging. Common etiologies include fluid and electrolyte disturbances, infections, drug toxicity, drug withdrawal and metabolic derangements. Many routine labs drawn in the evaluation of acute encephalopathy are […]

Background: In March 2019, the CEO of our public teaching hospital set a goal for the institution to become a high reliability organization. At that time, the hospital’s rates of catheter associated urinary tract infections (CAUTIs), central line associated blood stream infections (CLABSIs), and hospital acquired pressure injuries (HAPIs) were above the national average. Evaluation […]

Background: While multiple organizations have recommended reducing unnecessary and repetitive lab tests in hospitalized patients, this has not resulted in a widespread change in behavior. There is agreement that unwarranted labs increase costs, but data around specific lab costs have not been readily available. At baseline, there were 125,586 labs ordered by the UNC Rex […]