Background: Peripherally inserted central catheters (PICCs) are associated with an increased risk of central line-associated bloodstream infection (CLABSI) and venous thromboembolism (VTE). Catheters that are coated or impregnated with antimicrobial and/or antithrombotic agents have been developed to prevent these complications. However, their effectiveness in preventing CLABSI and VTE is unclear. Using data from a large [...]

Background: The placement of peripherally inserted central catheters (PICCs) is increasingly performed primarily by vascular access nurses (VAN) in United States hospitals1. Despite the increased use of these specially trained clinicians, little is known about the patient and device characteristics of the PICCs they placed compared to those placed by interventional radiology (IR) providers. While [...]

Background: Peripherally inserted central catheters (PICCs) are frequently used to deliver intravenous (IV) antibiotic therapy. Infectious disease (ID) physicians are often consulted prior to PICC placement, but whether their engagement influences PICC appropriateness and complications is not known. Methods: Using data from the Michigan Hospital Medicine Safety Consortium on PICCs placed in hospitalized medical patients [...]

Background: Peripherally inserted central catheters (PICCs) are essential devices used to provide central venous access. However, they are often placed inappropriately, leading to unnecessary risk of PICC-related complications. Vascular access operators typically place the majority of PICCs, yet little is known about these specialists and their beliefs regarding PICCs. We therefore conducted a national survey [...]

Background: Improving the appropriate use of peripherally inserted central catheters (PICC) has been shown to reduce the rates of PICC-associated complications. However, quality improvement (QI) programs that promote appropriate PICC use may require significant financial investment. We evaluated the cost-effectiveness of the Michigan Hospital Medicine Safety (HMS) PICC QI initiative, a physician-led, performance-incentivized, QI intervention [...]

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 [...]

Background: Growing use of peripherally inserted central catheters (PICCs) has led to the development of certification programs for PICC operators. Much like the debate regarding certification in medicine, whether such certification influences clinical care is unknown. This knowledge gap is relevant for health systems that hire operators based on certification status and for hospitalists who [...]

Background: Difficult intravenous access is a common challenge in patients with obesity, often resulting in placement of peripherally inserted central catheters (PICCs). However, little is known about the relationship between obesity and the risk of device-related complications in patients with PICCs. We sought to assess associations between obesity and PICC-related complications in hospitalized medical patients. [...]