Single-Lumen Peripherally Inserted Central Catheters as the Default Option

AUTHORS: Bozaan D et al.

J Hosp Med 2019 Jan 8

Studies suggest a strong association between the number of lumens in peripherally inserted central catheter (PICC) lines and risk for complications, including central line–associated bloodstream infections, venous thromboembolism, and catheter occlusions. Investigators at a Michigan academic medical center sought to promote use of single-lumen (rather than multi-lumen) PICC lines through a three-part quality improvement intervention: 1) education for hospitalist physicians, pharmacists, and vascular access nurses using a validated appropriateness guide; 2) multidisciplinary development of indications for multi-lumen catheters; and 3) modification of the electronic medical record (EMR) to make single-lumen PICCs the default option (multi-lumen requests to be justified by the clinician and reviewed by a vascular access nurse or pharmacist).

A total of 226 PICC lines were placed during a 10 month-period, with no change in the average number of monthly PICC requests after the intervention, but with a significant reduction in use of multi-lumen PICC lines (35% preintervention vs. 6% postintervention). Placement of PICC lines with appropriate number of lumens significantly increased (74% preintervention vs. 98% postintervention).