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Efficacy of multifaceted interventions in reducing complications of peripherally inserted central catheter in adult oncology patients
Supportive Care in Cancer, 10/05/09

Tian G et al. – The results suggest that these interventions implemented in this study may help in reducing complications of PICC in adult oncology patients.

• Multifaceted interventions implemented in our department in December 2006
• Mandatory nurse reeducation developed by multidisciplinary task force
• Modification of peripherally inserted central catheter insertion: take a chest X-ray before removal of the guidewire and cutting of the catheter. The guidewire in the catheter facilitates the accurate location of the tip of PICC on chest X-ray and make the malposition correction (withdrawing, reinsertion, even reinsertion following withdrawal) easily
• Using a 2% chlorhexidine preparation, replace 10% povidone iodine for skin antisepsis
• Maintenance of maximum sterile barrier precautions during PICC insertion and aftercare
• Designing of PICC archive form and establishing a PICC archive for each patient. The PICC complication rates of groups before and after interventions evaluated and compared

• 69 PICC lines were inserted before these interventions, and 165 were inserted after implementation of these interventions
• Compared with preintervention group, postintervention group associated with 62.14% decrease in overall complication rate (11.52% vs 30.43% ; incidence density, 1.82 vs 4.62 per 1,000 PICC days) with a 67.48% decrease in the infective complications rate (4.24% vs 13.04% ) with a 58.19% decrease in noninfective complications rate (7.27% vs 17.39% [P?=?0.0199])

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