title: Reduction of peripherally inserted central catheter-associated DVT.
abstract: BACKGROUND
  As peripherally inserted central catheter (PICC) use has increased, so has the upper extremity DVT rate. PICC diameter may pose the most modifiable risk for PICC-associated DVT.
  
  
  METHODS
  A 3-year, prospective, observational study of all PICC insertions by a specially trained and certified team using a consistent and replicable approach was conducted at a 456-bed, level I trauma and tertiary referral hospital during January 1, 2008, through December 31, 2010. An intensified effort by the PICC team in 2010 was introduced to discuss and reach interdisciplinary consensus on the need for each lumen of the PICC and a change to smaller diameter 5F triple-lumen PICC.
  
  
  RESULTS
  Significantly more 4F single-lumen PICCs were used during 2010 (n = 470) compared with 2008 and 2009 (n = 338, 382; P < .0001). DVT rates were similar with the use of 5F triple-lumen PICCs in 2010 as 5F double-lumen PICCs and lower rates than 6F triple-lumen catheters used in 2008 and 2009. The PICC-associated DVT rate was significantly lower (1.9% vs 3.0%, P < .04) in 2010 compared with 2008 and 2009. The cost and length of stay attributable to PICC-associated DVT were $15,973 and 4.6 days.
  
  
  CONCLUSIONS
  A significant increase in the use of single-lumen PICCs in addition to the institutional adoption of smaller 5F triple-lumen PICCs was associated with a significant decrease in the rate of PICC-associated DVT.
authors.affiliation: Medical Informatics, Intermountain Healthcare, Salt Lake City, UT; Biomedical Informatics, Salt Lake City, UT. Electronic address: rscott.evans@imail.org.
authors.forename: R Scott
authors.initials: RS
authors.lastname: Evans
authors.affiliation: Nutrition Support Service/PICC Team, Salt Lake City, UT.
authors.forename: Jamie H
authors.initials: JH
authors.lastname: Sharp
authors.affiliation: Nutrition Support Service/PICC Team, Salt Lake City, UT.
authors.forename: Lorraine H
authors.initials: LH
authors.lastname: Linford
authors.affiliation: Medical Informatics, Intermountain Healthcare, Salt Lake City, UT.
authors.forename: James F
authors.initials: JF
authors.lastname: Lloyd
authors.affiliation: Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT; Department of Medicine, Intermountain Medical Center, Salt Lake City, UT.
authors.forename: Scott C
authors.initials: SC
authors.lastname: Woller
authors.affiliation: Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT; Department of Medicine, Intermountain Medical Center, Salt Lake City, UT.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Stevens
authors.affiliation: Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT; Department of Medicine, Intermountain Medical Center, Salt Lake City, UT.
authors.forename: C Gregory
authors.initials: CG
authors.lastname: Elliott
authors.affiliation: Medical Informatics, Intermountain Healthcare, Salt Lake City, UT.
authors.forename: Jacob S
authors.initials: JS
authors.lastname: Tripp
authors.affiliation: RAND Corporation, Salt Lake City, UT.
authors.forename: Spencer S
authors.initials: SS
authors.lastname: Jones
authors.affiliation: Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT; Department of Medicine, Intermountain Medical Center, Salt Lake City, UT; Hyperbaric Medicine, Intermountain Medical Center and LDS Hospital, Salt Lake City, UT.
authors.forename: Lindell K
authors.initials: LK
authors.lastname: Weaver
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002406:Catheterization, Peripheral / Q000009:adverse effects; D002408:Catheters, Indwelling / Q000009:adverse effects; D002648:Child; D004867:Equipment Design; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D056824:Upper Extremity Deep Vein Thrombosis / Q000453:epidemiology; D020246:Venous Thrombosis / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult