Background: Peripherally inserted central catheters (PICCs) are becoming increasingly popular due to their ease of insertion through upper extremity veins, although they are not complications-free. PICCs can be irritating and cause endothelial injury and inflammation resulting in venous thrombosis. Estimates suggest that more than a third of all deep venous thrombosis (DVT) in the upper [...]

Background: Multi-lumen (ML) peripherally inserted central catheters (PICCs) are associated with increased risk of central line associated blood stream infection (CLABSI), venous thromboembolism (VTE) and increased cost compared to single lumen (SL) PICCs. Current guidelines recommend minimizing the number of PICC lumens. However, there is a paucity of literature to guide the selection of SL [...]

Background: Peripherally inserted central catheters (PICCs) are associated with central vein stenosis and failure to establish a functioning arteriovenous fistula. Thus, guidelines recommend avoiding PICC placement when patients with chronic kidney disease (CKD) are likely to require hemodialysis. We sought to describe the current practice of PICC placement in hospitalized patients with an estimated glomerular [...]

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: 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: 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 [...]