Neonatal and Pediatric Medicine
Open Access

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.

Biography

Rui Wang is an experienced RN, worked in neonatal nursing field for 24 years. She has multiple certifications related to neonatal nursing, PICC RN, RNC-NIC, ECMO, SDU (special delivery unit RN), BRN (breastfeeding resource RN). She serves as a Clinical Resource Nurse for bedside nurses, clinicians and families. She has successfully placed close to 400 PICCs for neonatal patients; the smallest patient weighed 450 grams. She was named as one of NICU PICC RN team co-leaders since May 2016. She has created online community for PICC team in 2016, which serves as an efficient communication and data collection tool.

E-mail: wangr@chop.edu