title: Peripherally Inserted Central Catheter Use in Skilled Nursing Facilities: A Pilot Study.
abstract: OBJECTIVE
  To describe patterns of use, care practices, and outcomes related to peripherally inserted central catheter (PICC) use in skilled nursing facilities (SNFs).
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Two community SNFs.
  
  
  METHODS
  Adult SNF residents with PICCs (N = 56).
  
  
  METHODS
  Information on indication for PICC use, device characteristics (e.g., lumens, gauge), and participant data (comorbidities, medications) were obtained from medical records. Care practices (e.g., frequency of flushing, dressing care) and problems related to PICCs were recorded. Major (central line-associated bloodstream infection, venous thromboembolism, catheter dislodgement) and minor (migration, dressing disruption, lumen occlusion, exit site infection) complications and process measures (flushing of PICC, assessment of necessity) were recorded. Bivariate analyses with t-tests, chi-square tests, or Fischer exact tests were used for continuous and categorical data.
  
  
  RESULTS
  Participants were enrolled from two SNFs. The most common indication for PICC use was intravenous antibiotic delivery. The average PICC dwell time was 43 days, and most devices were single-lumen PICCs. Major and minor complications were common and occurred in 11 (20%) and 18 (32%) participants, respectively. Occlusion (23%, n = 13), accidental dislodgement (12%, n = 7), and dressing disruption (11%, n = 6) were the commonest complications observed. Documentation regarding catheter care practices occurred in 41% of cases.
  
  
  CONCLUSIONS
  Quality improvement efforts that seek to benchmark practice, identify gaps, and institute efforts to improve PICC care and practice in SNFs appear necessary.
authors: Patient Safety Enhancement Program and Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.|Division of General Internal Medicine, Department of Medicine, University of Michigan Health System, Ann Arbor, Michigan.
authors: Vineet
authors: V
authors: Chopra
authors: Geriatrics Research, Education and Clinical Center, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.|Division of Geriatric and Palliative Care Medicine, University of Michigan Health System, Ann Arbor, Michigan.
authors: Ana
authors: A
authors: Montoya
authors: Geriatrics Research, Education and Clinical Center, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.|Division of Geriatric and Palliative Care Medicine, University of Michigan Health System, Ann Arbor, Michigan.
authors: Darius
authors: D
authors: Joshi
authors: Patient Safety Enhancement Program and Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.
authors: Carol
authors: C
authors: Becker
authors: Patient Safety Enhancement Program and Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.
authors: Amy
authors: A
authors: Brant
authors: Patient Safety Enhancement Program and Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.|Division of General Internal Medicine, Department of Medicine, University of Michigan Health System, Ann Arbor, Michigan.
authors: Helen
authors: H
authors: McGuirk
authors: Patient Safety Enhancement Program and Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.
authors: Jordyn
authors: J
authors: Clark
authors: Patient Safety Enhancement Program and Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.
authors: Molly
authors: M
authors: Harrod
authors: Patient Safety Enhancement Program and Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.|Division of General Internal Medicine, Department of Medicine, University of Michigan Health System, Ann Arbor, Michigan.
authors: Latoya
authors: L
authors: Kuhn
authors: Geriatrics Research, Education and Clinical Center, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.|Division of Geriatric and Palliative Care Medicine, University of Michigan Health System, Ann Arbor, Michigan.
authors: Lona
authors: L
authors: Mody
mesh_terms: D000368:Aged; D002405:Catheterization, Central Venous / Q000379:methods* / Q000706:statistics & numerical data*; D002406:Catheterization, Peripheral; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D012866:Skilled Nursing Facilities
keywords: central line-associated bloodstream infection; deep vein thrombosis; peripherally inserted central catheter; skilled nursing facility; venous thromboembolism