Rui Wang
Children’s Hospital of Philadelphia, USA
Title: Nurse-led central line initiative: Protecting patients from harm
Biography
Biography: Rui Wang
Abstract
Staff nurses sought to shorten time to central line access for a vulnerable population. This harm prevention initiative included reducing injury from peripheral intravenous lines. Critically ill infants often require long term parenteral medications and nutrition. More consistent delivery, along with lowered risk of injury from PIVs are benefits of Peripherally Inserted Central Catheter (PICC) access for neonates. Many factors are related to timely line placement such as location of procedure; NIICU bedside versus interventional radiology, expertise of staff for insertion and patient safety. We sought to increase bedside PICC access as best practice. Ten experienced registered nurses in our NIICU were selected. The group completed required pediatric PICC qualification training to function independently. The team's objectives included shortening time to PICC placement, reducing patient harm by decreasing PIV extravasation and infiltrates and decreasing Central Line Associated Blood Stream Infections (CLABSIs), thereby contributing to decrease costs and shortened length of stay. Team leaders developed resources to facilitate communication and guide practice using a web-based community to improve efficiency and provide data collection tools to track outcomes; also creating an algorithm for PICC placement, annual competency for PICC team and a bedside PICC attempt job aid. Positive outcomes included: Decreased PICC waiting time, increased number of PICC lines placed at bedside versus patient transport to IR, limiting time delay and potential infant safety risks and significantly decreased in grade 3 and 4 PIV infiltrations. Based on positive outcomes of this nurse-led project, PICC team provides 24*7 care for NIICU patients.