Neonatal peripherally inserted central catheters: recommendations for prevention of insertion and postinsertion complications.
Peripherally inserted central catheters (PICCs) continue to be necessary in neonatal care. They benefit many premature infants and those needing long-term intravenous access. An experienced inserter, early recognition of PICC candidates, early PICC placement, knowledge of anatomy, and correct choice of vein all increase placement success. As with any invasive procedure, there are risks. These include pain, difficulty advancing the catheter, damage to vessels, catheter malposition, and bleeding. Utilizing assessment skills, following the product manufacturer's instructions, and carefully placing the catheter should minimize most of these risks. Additional risks include postinsertion complications such as occlusions, thrombosis, catheter failure, infection, and catheter malposition. Proper nursing care--which includes controlling infection, properly securing the catheter, and changing the dressing as needed--is key to preventing complications and maintaining the PICC until treatment has been completed.
Paulson
Pamela R
PR
Denver Health Medical Center, Denver, Colorado 80204, USA. ppaulson@dhha.org
Miller
Kellee M
KM
D001458:Bandages; D002406:Catheterization, Peripheral / Q000009:adverse effects* / Q000451:nursing; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002983:Clinical Competence; D003428:Cross Infection / Q000209:etiology / Q000517:prevention & control; D004868:Equipment Failure; D006801:Humans; D007231:Infant, Newborn; D017053:Infection Control; D015931:Intensive Care, Neonatal / Q000379:methods; D017283:Neonatal Nursing / Q000379:methods*; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D018579:Patient Selection; D010689:Phlebitis / Q000209:etiology / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D017751:Safety Management / Q000379:methods*; D017592:Skin Care / Q000379:methods / Q000451:nursing; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control