Vineet Chopra1, Latoya Kuhn, Scott A Flanders, Sanjay Saint, Sarah L Krein. 1. Patient Safety Enhancement Program and the Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan; Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan.
Abstract
BACKGROUND: A Michigan survey found variation in hospitalist-reported experience, practice, opinions, and knowledge related to peripherally inserted central catheters (PICCs). Whether these findings reflect a national trend is unknown. OBJECTIVE: To investigate self-reported PICC practice among adult hospitalists in the United States. METHODS: Society of Hospital Medicine-administered, anonymous, Web-based survey of practicing, adult, non-Michigan hospitalists. RESULTS: Of the 2112 hospitalists who were sent an electronic invitation, 381 completed the online survey (18%). Eighty-six percent of hospitalists reported having placed a PICC solely for venous access (vs specific indications such as long-term antibiotics or parenteral nutrition). Eighty-two percent reported having cared for a patient who specifically requested a PICC. Only 25% of hospitalists reported examining PICCs for evidence of external problems, whereas 57% admitted to having, at least once, forgotten about the presence of a PICC. Only 9% of respondents knew that PICC tip verification was performed primarily to prevent venous thromboembolism. Finally, 42% of participants indicated that 10% to 25% of PICCs placed in their hospitals might be inappropriately placed and/or avoidable. CONCLUSIONS: This national survey highlights several potential opportunities to improve hospitalist PICC practices. A research agenda dedicated to this issue is necessary to improve patient safety and hospital-based practice.
BACKGROUND: A Michigan survey found variation in hospitalist-reported experience, practice, opinions, and knowledge related to peripherally inserted central catheters (PICCs). Whether these findings reflect a national trend is unknown. OBJECTIVE: To investigate self-reported PICC practice among adult hospitalists in the United States. METHODS: Society of Hospital Medicine-administered, anonymous, Web-based survey of practicing, adult, non-Michigan hospitalists. RESULTS: Of the 2112 hospitalists who were sent an electronic invitation, 381 completed the online survey (18%). Eighty-six percent of hospitalists reported having placed a PICC solely for venous access (vs specific indications such as long-term antibiotics or parenteral nutrition). Eighty-two percent reported having cared for a patient who specifically requested a PICC. Only 25% of hospitalists reported examining PICCs for evidence of external problems, whereas 57% admitted to having, at least once, forgotten about the presence of a PICC. Only 9% of respondents knew that PICC tip verification was performed primarily to prevent venous thromboembolism. Finally, 42% of participants indicated that 10% to 25% of PICCs placed in their hospitals might be inappropriately placed and/or avoidable. CONCLUSIONS: This national survey highlights several potential opportunities to improve hospitalist PICC practices. A research agenda dedicated to this issue is necessary to improve patient safety and hospital-based practice.
Authors: Vineet Chopra; Sushant Govindan; Latoya Kuhn; David Ratz; Randy F Sweis; Natalie Melin; Rachel Thompson; Aaron Tolan; James Barron; Sanjay Saint Journal: Ann Intern Med Date: 2014-10-21 Impact factor: 25.391