I had been told that there have been more problems with PICC lines ( infections, DVTs etc.) so that the trend was leaning more towards non- tunneled central lines as the best option for patients.
Infection risks are virtually the same with PICCs and other percutaneous CVADs. PICCs have a higher rate of vein thrombosis than other percutaneous CVADs for several reasons. But infection rates are certainly not higher with PICCs. In fact, the profile of skin organisms at the PICC insertion site on the upper arm is very different from the IJ or subclavian sites, thus favoring lower infection risks with PICCs. The infection risk with CVADs is also from the hub and intraluminal causes. This risk is exactly the same with all CVADs and becomes the prevailing cause of CRBSI with dwell time longer than a couple of weeks.
The prevailing trend is to move away from ALL CVADs. No CVAD means no CLABSI, which means none reported to CDC and CMS. CLABSI rates have a dramatic impact on Medicare payments to a facility. So the movement is away from CVADs and over the PIVs and midline which do not get reported if they become infected. So these infections still happen but are not tracked and reported, and thus no impact on reimbursement. The huge issue is that many therapies can not or should not be infused through peripheral veins. The key is to know the difference and choose CVAD use wisely and appropirately.
Also, do not fall into the trap of having others force you to do the literature searching. Anyone trying to make a point such as this should be professional enough to find their own literature. Just a strong personal issue I have with others trying to force nurses to do their legwork! Lynn
No. The rates are about the same
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
Thank you Ms. Hadaway,
I had been told that there have been more problems with PICC lines ( infections, DVTs etc.) so that the trend was leaning more towards non- tunneled central lines as the best option for patients.
Infection risks are virtually the same with PICCs and other percutaneous CVADs. PICCs have a higher rate of vein thrombosis than other percutaneous CVADs for several reasons. But infection rates are certainly not higher with PICCs. In fact, the profile of skin organisms at the PICC insertion site on the upper arm is very different from the IJ or subclavian sites, thus favoring lower infection risks with PICCs. The infection risk with CVADs is also from the hub and intraluminal causes. This risk is exactly the same with all CVADs and becomes the prevailing cause of CRBSI with dwell time longer than a couple of weeks.
The prevailing trend is to move away from ALL CVADs. No CVAD means no CLABSI, which means none reported to CDC and CMS. CLABSI rates have a dramatic impact on Medicare payments to a facility. So the movement is away from CVADs and over the PIVs and midline which do not get reported if they become infected. So these infections still happen but are not tracked and reported, and thus no impact on reimbursement. The huge issue is that many therapies can not or should not be infused through peripheral veins. The key is to know the difference and choose CVAD use wisely and appropirately.
Also, do not fall into the trap of having others force you to do the literature searching. Anyone trying to make a point such as this should be professional enough to find their own literature. Just a strong personal issue I have with others trying to force nurses to do their legwork! 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