Peripherally Inserted Central Catheters (PICC) and the Efficacy of Tip Placement Confirmation with ECG Ultrasound-Guided Technology and Chest Radiography

Abstract

AIM: The aim of this study was to appraise the efficacy of peripherally inserted central catheters (PICC) tip placement confirmation using a fully-integrated magnetic tracking system and ECG ultrasound-guided insertion technology performed at the patients’ bedside by venous access nurses and validated by the post-insertion chest radiography (CXR) report. Labor costs and time were compared with the interventional radiology (IR) team and the venous access nurses to determine if there was a noteworthy cost difference with PICC insertions.

BACKGROUND: PICCs have gained popularity due to improved ECG ultrasound-guided tip navigation technology. Real-time ECG ultrasound-guided technology is the safest, most accurate method of PICC insertion.

METHODS: A retrospective chart review of 125 adults between 18 to 90 years of age who met the indications for a PICC that were inserted at the bedside by competent venous access nurses. Post insertion CXR were compared for accurate tip placement.

RESULTS: A sample of 125 patients had bedside PICCs inserted by qualified venous access nurses from July 2016 to June 2017 in one southern California acute care hospital. Study findings revealed 97.6% of PICCs was properly placed as validated by post CXR. Demographics included age (Mean = 62 years, Range 25-86) and gender (70.4% male, 29.6% female). No complications occurred during PICC insertions. A separate cost comparison of average labor costs during PICC insertions was measured among bedside venous access nurses and interventional radiology. Labor costs for venous access nurses performing PICC insertions were $67.47 (75 minutes) versus $81.17 (110 minutes) in interventional radiology, a cost savings of $13.70 per PICC insertion.