Neonatal Peripherally Inserted Central Catheter Practices and Providers

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Sharpe, E
Kuhn, L
Ratz, D
Krein, SL
Chopra, V
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2017
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Abstract

Background: Neonatal intensive care units (NICUs) commonly utilize peripherally inserted central catheters (PICCs) to provide nutrition and long-term medications to premature and full-term infants. However, little is known about PICC practices in these settings. Purpose: To assess PICC practices, policies, and providers in NICUs. Methods: The Neonatal PICC1 Survey was conducted through the use of the electronic mailing list of a national neonatal professional organization's electronic membership community. Questions addressed PICC-related policies, monitoring, practices, and providers. Descriptive statistics were used to assess results. Results: Of the 156 respondents accessing the survey, 115 (73.7%) indicated that they placed PICCs as part of their daily occupation. Of these, 110 responded to at least one question (70.5%) and were included in the study. Reported use of evidence-based practices by NICU providers varied. For example, routine use of maximum sterile barriers was reported by 90.4% of respondents; however, the use of chlorhexidine gluconate for skin disinfection was reported only by 49.4% of respondents. A majority of respondents indicated that trained PICC nurses were largely responsible for routine PICC dressing changes (61.0%). Normal saline was reported as the most frequently used flushing solution (46.3%). The most common PICC-related complications in neonates were catheter migration and occlusion. Implications for Practice: Variable practices, including the use of chlorhexidine-based solutions for skin disinfection and inconsistent flushing, exist. There is a need for development of consistent monitoring to improve patient outcomes. Implications for Research: Future research should include exploration of specific PICC practices, associated conditions, and outcomes.

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Advances in Neonatal Care

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17

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3

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Clinical sciences

Paediatrics

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Sharpe, E; Kuhn, L; Ratz, D; Krein, SL; Chopra, V, Neonatal Peripherally Inserted Central Catheter Practices and Providers, Advances in Neonatal Care, 2017, 17 (3), pp. 209-221

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