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: Evidence suggests that risk of central line-associated bloodstream infection (CLABSI) between patients with traditional central venous catheters (CVC) vs. peripherally inserted central catheters (PICC) is similar. However, how best to predict CLABSI in patients with PICCs is not known.  Methods: We used data from the Michigan Hospital Medicine Safety (HMS) Consortium, a 51-hospital Blue [...]

Background: Central line-associated bloodstream infection (CLABSI) is a preventable complication. In the United States, there are more than 20,000 CLABSI per year, resulting in a cost of about $30,000 per infection. A number of interventions have been employed to decrease the risk of CLABSI. Previous studies have documented the importance of simulation-based training. There is [...]

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: Since being introduced in the 1950s, midlines have since gained attention as an intravascular access option—particularly in patients requiring intravenous (IV) therapy for extended time periods. They provide an alternative to frequent venipuncture from peipheral intravenous catheters (PIV) and may reduce cost and increase patient satisfaction. The CDC and MAGIC guidelines currently recommend the [...]

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: 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 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: 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 [...]