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John Hallowell
Cost of PICCs at bedside compared to IR

Does anyone have specific information/articles on the costs of performing PICCs bedside compared to Interventional Radiology? Also, what is the national percentage of PICCs performed bedside compared to Interventional Radiology?

lynncrni
 The most recent data on

 The most recent data on costs that I know about can be found in this article but I don't think it provides a cost comparision between bedside and IR placement. Most IR placement costs I have seen in the past is around $800-900 without the costs of the professional fees charged by the physician. 

1. Roszell S, Jones C. Intravenous administration issues: a comparison of intravenous insertions and complications in vancomycin versus other antibiotics. J Infus Nurs. Mar-Apr 2010;33(2):112-118.

With MST and US, the success rates at bedside went to more than 90% and in some places more than 95%. That does not include those hospitals that have not moved this procedure to the bedside and I have never seen any national data on bedside vs IR placement. You may find some numbers in individual studies but there is no way to obtain national data because there is no public national database for this. There is the PICC Registry service that is a private database and maybe someone can let us know how many are using this service now. Lynn

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

John Hallowell
Thank you. How about a

Thank you. How about a general estimate of the percentage of PICCs performed at bedside compared to IR?

John Hallowell, PA-C, MBA

Director of Physician Assistant Services

Southside Hospital

301 East Main St.

Bay Shore, N.Y. 11706

lynncrni
 I would not be able to even

 I would not be able to even guess at that, however I think the number is very small. We simply do not need to rely upon radiology anymore due to ultrasound at bedside for finding the vein and performing venipuncture. For tip location we now have ECG, which is even eliminating the use of post-procedure chest xray. I would guess that less than 10% of insertions require IR and fluoroscopy for insertion, maybe more like less than 5%, but have no basis for this except a guess. Lynn

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

kathykokotis
70 % bedside / 30% suite -

70 % bedside / 30% suite - did my best on cut and paste

Appendix :  Published costs to place PICC Line in a suite and at the bedside

Author

Facility

Year cited

published

Suite cost placement

Bedside cost placement

Difference

Naylor16

Santa Rosa Memorial Hospital

California

2007

$700*

$305**

$395*

Kokotis14

Based on published literature

2001

$450*

150

$300*

Dobson8

Lutheran Medical Center Arizona

1999

2001

$195*

$88

$77*

Hornsby12

Covenant Healthcare Systems Michigan

2002

2005

$1,694

$817

$877

Neuman17

Beth Israel Deaconess Medical Center Mass.

1998

$107 (PICC)

$128 (venogram

$150-$200 (suite/hour)

$435*

$107 (PICC)

$29 (x-ray)

$23 (RN)

$159

$276

Robinson20

Brigham and Women’s Hospital Mass

2000

2004

$465*

$170

$295

Santolucito22

Oregon Health Science University Hospital

1999

2001

$500-$850*

$200

$300*-$650*

Cardella5

Penn State University Hospital

1996

$850-$1,000*

(charge)

$286-$300

(charge)

$550-$700*

Croteau6

Abstract

Henry Ford Hospital

Michigan

Cited by author

2009

NR

NR

$713

Royer21

VA Hospital Seattle

2000

2001

$978*

$156

$822*

Health Care Advisory Board Fact Brief11

Washington D.C. consulting firm

1999

$1,000

$1,500

$3,000

Patient charge noted

Operational cost noted

$150-$200

$800

$1.300

$2,800

 

*Does not include physician fees

**placement includes navigation costs and (2) hours of RN labor at $50.00 an hour

***patient charge based with charge for ultrasound

 

Carole Fuseck
Good info

Lynn, thank you for the article.

Kathy, thank you for the references and table of cost comparisons.  We are having discussions at my facility about IR vs. bedside placement and this list is perfect timing.  I am going to share with my new manager and the CNO.

Carole

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