In my opinion PICC/Midline insertions in LTC can be more challenging at times than in a hospital setting. Some obstacles in LTC may be beds that do not go up, poor lighting, working solo and agitated and confused patients. I strive for 98% success rate as I had in the hospital setting but some months fall short. My question is, are there any national benchmarks for PICC/Midline success rates specific to LTC?
There are no national benchmarks published as far as I know or have seen but, I agree with you completely regarding increase challenge in LTAC settings vs STAC facilities. We are a LTAC hospital group and have a 98% success rate with 100-150 PICC's and 10 - 15 Central Lines placed /month. We do NO midlines as they are glorified peripherals and are of little to no value in a LTAC setting. Some of the obstacles you mentioned are very real. Our patients have numerous, previous insertions that contribute to the complexity of new insertions. Finding a virgin vein is cause for celebration. Due to these we always work in teams of 2. This provides for the contacted, agitated and confused patients where a second hand is not only helpful but warranted if your sucess rate is to stay high. We found that doing insertions in teams also has the additional benefit of faster insertion times and reduced sterile technique breaks. We have found it is just a better way to practice!