Placing Bedside PICC Lines in the PICU

Increase Effectiveness and Efficiency
Keep Patients Safe

Why is this important?

In the Pediatric Intensive Care Unit (PICU), patients frequently require peripherally inserted central catheters (PICCs) for their treatment. Moving a patient from the critical care setting to the Interventional Radiology (IR) suite, where PICC placement is usually performed, can disrupt ongoing medical care and may delay treatment. Vital PICU staff, including nurses, respiratory therapists, and physicians must accompany the patient which can put stress on the ICU environment. This team wanted to show that PICC lines placed by trained providers at the bedside in the ICU is an efficient and safe alternative for some critically ill patients.

What we did

PICU doctors were trained by IR doctors and began placing PICC lines at the bedside. After demonstrating success, they partnered with the nurse vascular access specialists and developed standardized patient selection criteria. They implemented a line placement assessment tool to enhance communication around the patients’ vascular access needs and continued to increase the number of providers trained.

Results

The PICU successfully increased the number of PICC lines placed at the bedside and demonstrated a 95 percent success rate and had no increase in central line associated blood stream infection (CLABSI) rates. The PICU bedside procedure reduces time to line placement significantly. This multi-departmental initiative to select eligible patient for bedside PICC placement, trained providers in the required technical skills for successful placement, and developed effective communication tools resulting in PICC lines being placed in a timely, safe and efficient manner in the PICU.

Updated October, 2018