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: Catheter-associated urinary tract infection (CAUTI) is a common and clinically important hospital-associated infection throughout the world. A few data from Japan exist regarding the prevalence and appropriateness of urinary catheters in hospitalized patients but no interventions have been proven to decrease unnecessary urinary catheter use in Japan. Our aim of this study is to [...]

Background: The Joint Commission’s Surgical Care Improvement Project (SCIP)-9 recommended removing indwelling urinary catheters (IUC) before postoperative day 2 to decrease urinary infection (UTI) risk. Our center implemented a best practice alert (BPA) in the electronic health record to enforce SCIP-9 with near-100% compliance.  We sought to study the effect of the BPA on catheter [...]

Background: Midlines are peripheral vascular devices inserted in the veins of the upper extremity with the tip located at or below the axillary vein. Complications associated with peripherally inserted central catheter (PICC) along with documented overuse has led to emerging interest and increasing use of midlines. However, whether midlines are safer than PICCs is not [...]

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: Indwelling urinary catheters (IDUCs) are commonplace in hospital medicine wards, facilitating patient care but introducing risks such as catheter-associated urinary tract infections (CAUTIs). The urgency to minimize these complications has spurred initiatives to refine catheter utilization protocols. This study examines the efficacy of the Foley Removal Countdown Strategy, a novel, proactive approach in the [...]

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: Vascular access devices (VADs) play an integral role in the treatment of patients, since they can be utilized for the administration of intravenous medications (including antibiotics and chemotherapy), and often on a long term basis. A peripherally inserted central catheter (PICC) is a type of VAD, which is frequently utilized in different populations. Once [...]

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: Peripherally inserted central catheters (PICCs) are an increasingly common vascular access device, with more than 4000 devices placed per year at our institution. Though these devices are generally considered safe and effective, they are not without risks, particularly of catheter-related infection and thrombosis. These risks increase exponentially with increasing number of lumens. At our [...]