Improved care and reduced costs for patients requiring peripherally inserted central catheters

The role of bedside ultrasound and a dedicated team

Malcolm K. Robinson, Kris M. Mogensen, Gina F. Grudinskas, Sharon Kohler, Danny O. Jacobs

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

Background: We conducted a prospective quality assurance (QA) study to determine if a team dedicated to placing peripherally inserted central catheters (PICCs) would improve patient care and reduce costs. Methods: In April 2000, a dedicated team of physicians, physician assistants, nurses, and interventional radiologists (IR) was established to coordinate and approve all PICC placements at our hospital. Ultrasound (US) became available in November 2000 to assist with bedside PICC placement. A QA database was created allowing data from 3 time periods reflecting initiation of the PICC service (April-June 2000), initial implementation of bedside US-guided PICC placement (October-December 2000), and the current service (October-December 2002) to be analyzed and compared. Results: For all time periods analyzed, the PICC team found that one-third of PICC requests was inappropriate and, therefore, disapproved placement. With addition of US, the bedside PICC placement rate increased to 94% compared with 73% at service initiation. This was associated with an overall 80% decrease in average patient waiting time for a PICC, facilitating more timely discharges from the hospital. Finally, placement costs were reduced by 9% six months after initiation of our service and by 24% after US became available. Conclusions: A dedicated PICC team improves patient care by preventing inappropriate PICC placements and decreasing patient waiting times. A PICC team with US capability also reduces costs by minimizing expensive use of IR facilities and reducing hospital lengths of stay. A dedicated PICC service should become the standard of care for all hospitals with high-volume PICC use.

Original languageEnglish (US)
Pages (from-to)374-379
Number of pages6
JournalJournal of Parenteral and Enteral Nutrition
Volume29
Issue number5
DOIs
StatePublished - Sep 2005
Externally publishedYes

Fingerprint

catheters
Catheters
Costs and Cost Analysis
patient care
physicians
quality control
Length of Stay
High-Volume Hospitals
Physician Assistants
Patient Care Team
nurses
Standard of Care
Patient Care
Nurses
Databases

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Food Science

Cite this

Improved care and reduced costs for patients requiring peripherally inserted central catheters : The role of bedside ultrasound and a dedicated team. / Robinson, Malcolm K.; Mogensen, Kris M.; Grudinskas, Gina F.; Kohler, Sharon; Jacobs, Danny O.

In: Journal of Parenteral and Enteral Nutrition, Vol. 29, No. 5, 09.2005, p. 374-379.

Research output: Contribution to journalArticle

Robinson, Malcolm K. ; Mogensen, Kris M. ; Grudinskas, Gina F. ; Kohler, Sharon ; Jacobs, Danny O. / Improved care and reduced costs for patients requiring peripherally inserted central catheters : The role of bedside ultrasound and a dedicated team. In: Journal of Parenteral and Enteral Nutrition. 2005 ; Vol. 29, No. 5. pp. 374-379.
@article{1024bec9aa4f44e497afbceb265052fa,
title = "Improved care and reduced costs for patients requiring peripherally inserted central catheters: The role of bedside ultrasound and a dedicated team",
abstract = "Background: We conducted a prospective quality assurance (QA) study to determine if a team dedicated to placing peripherally inserted central catheters (PICCs) would improve patient care and reduce costs. Methods: In April 2000, a dedicated team of physicians, physician assistants, nurses, and interventional radiologists (IR) was established to coordinate and approve all PICC placements at our hospital. Ultrasound (US) became available in November 2000 to assist with bedside PICC placement. A QA database was created allowing data from 3 time periods reflecting initiation of the PICC service (April-June 2000), initial implementation of bedside US-guided PICC placement (October-December 2000), and the current service (October-December 2002) to be analyzed and compared. Results: For all time periods analyzed, the PICC team found that one-third of PICC requests was inappropriate and, therefore, disapproved placement. With addition of US, the bedside PICC placement rate increased to 94{\%} compared with 73{\%} at service initiation. This was associated with an overall 80{\%} decrease in average patient waiting time for a PICC, facilitating more timely discharges from the hospital. Finally, placement costs were reduced by 9{\%} six months after initiation of our service and by 24{\%} after US became available. Conclusions: A dedicated PICC team improves patient care by preventing inappropriate PICC placements and decreasing patient waiting times. A PICC team with US capability also reduces costs by minimizing expensive use of IR facilities and reducing hospital lengths of stay. A dedicated PICC service should become the standard of care for all hospitals with high-volume PICC use.",
author = "Robinson, {Malcolm K.} and Mogensen, {Kris M.} and Grudinskas, {Gina F.} and Sharon Kohler and Jacobs, {Danny O.}",
year = "2005",
month = "9",
doi = "10.1177/0148607105029005374",
language = "English (US)",
volume = "29",
pages = "374--379",
journal = "JPEN. Journal of parenteral and enteral nutrition",
issn = "0148-6071",
publisher = "SAGE Publications Inc.",
number = "5",

}

TY - JOUR

T1 - Improved care and reduced costs for patients requiring peripherally inserted central catheters

T2 - The role of bedside ultrasound and a dedicated team

AU - Robinson, Malcolm K.

AU - Mogensen, Kris M.

AU - Grudinskas, Gina F.

AU - Kohler, Sharon

AU - Jacobs, Danny O.

PY - 2005/9

Y1 - 2005/9

N2 - Background: We conducted a prospective quality assurance (QA) study to determine if a team dedicated to placing peripherally inserted central catheters (PICCs) would improve patient care and reduce costs. Methods: In April 2000, a dedicated team of physicians, physician assistants, nurses, and interventional radiologists (IR) was established to coordinate and approve all PICC placements at our hospital. Ultrasound (US) became available in November 2000 to assist with bedside PICC placement. A QA database was created allowing data from 3 time periods reflecting initiation of the PICC service (April-June 2000), initial implementation of bedside US-guided PICC placement (October-December 2000), and the current service (October-December 2002) to be analyzed and compared. Results: For all time periods analyzed, the PICC team found that one-third of PICC requests was inappropriate and, therefore, disapproved placement. With addition of US, the bedside PICC placement rate increased to 94% compared with 73% at service initiation. This was associated with an overall 80% decrease in average patient waiting time for a PICC, facilitating more timely discharges from the hospital. Finally, placement costs were reduced by 9% six months after initiation of our service and by 24% after US became available. Conclusions: A dedicated PICC team improves patient care by preventing inappropriate PICC placements and decreasing patient waiting times. A PICC team with US capability also reduces costs by minimizing expensive use of IR facilities and reducing hospital lengths of stay. A dedicated PICC service should become the standard of care for all hospitals with high-volume PICC use.

AB - Background: We conducted a prospective quality assurance (QA) study to determine if a team dedicated to placing peripherally inserted central catheters (PICCs) would improve patient care and reduce costs. Methods: In April 2000, a dedicated team of physicians, physician assistants, nurses, and interventional radiologists (IR) was established to coordinate and approve all PICC placements at our hospital. Ultrasound (US) became available in November 2000 to assist with bedside PICC placement. A QA database was created allowing data from 3 time periods reflecting initiation of the PICC service (April-June 2000), initial implementation of bedside US-guided PICC placement (October-December 2000), and the current service (October-December 2002) to be analyzed and compared. Results: For all time periods analyzed, the PICC team found that one-third of PICC requests was inappropriate and, therefore, disapproved placement. With addition of US, the bedside PICC placement rate increased to 94% compared with 73% at service initiation. This was associated with an overall 80% decrease in average patient waiting time for a PICC, facilitating more timely discharges from the hospital. Finally, placement costs were reduced by 9% six months after initiation of our service and by 24% after US became available. Conclusions: A dedicated PICC team improves patient care by preventing inappropriate PICC placements and decreasing patient waiting times. A PICC team with US capability also reduces costs by minimizing expensive use of IR facilities and reducing hospital lengths of stay. A dedicated PICC service should become the standard of care for all hospitals with high-volume PICC use.

UR - http://www.scopus.com/inward/record.url?scp=33644875193&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33644875193&partnerID=8YFLogxK

U2 - 10.1177/0148607105029005374

DO - 10.1177/0148607105029005374

M3 - Article

VL - 29

SP - 374

EP - 379

JO - JPEN. Journal of parenteral and enteral nutrition

JF - JPEN. Journal of parenteral and enteral nutrition

SN - 0148-6071

IS - 5

ER -