Abstract No. 532 - Reduction in fluoroscopy time during peripherally inserted catheter (PICC) placement

Abstract

The detrimental effects of ionizing radiation are well documented for both the patient and the performing healthcare practitioners. In order to reduce radiation exposure, we recorded fluoroscopy times and radiation dosages during peripherally inserted catheter (PICC) placement. We hypothesized that actively recording and monitoring these values will significantly decrease the average fluoroscopy time and radiation exposure. A single combined retrospective and prospective analysis was performed at our community based teaching hospital over a 12-month period. All PICC lines performed on the Toshiba Infinix I-series were included in our data set. A spreadsheet was developed to record: fluoroscopy time (mins), dose area product (CGycm2), and reference dose (mGy). We retrospectively evaluated these data in our pre-intervention group over a six month period (July 2013 to December 2013). After implementing the new policy, we prospectively evaluated the same data over the following six months (January 2014 to June 2014). The differences in fluoroscopy time and radiation exposure were compared between the two groups and statistical analysis was performed. A total of 100 procedures were included in the study, with both 50 in the pre and post intervention groups. The patient population for the pre intervention group has a male:female ratio of 33:17 with a mean age of 59.9 (range 79). Our post intervention group has a ratio 26:24 with a mean age 60.0 (range 64). The average fluoroscopy time between the two groups shows a statistically significant decrease of 35% (p = 0.02), from 1.33 min (standard deviation 1.18; range 4.7) to 0.86 min (standard deviation 1.20; range 5.8). The mean dose area product between the pre and post intervention groups also shows a statistically significant decrease of 44% (p = 0.02), from 60.73 CGycm2 (standard deviation 84.09; range 424.5) to 34.14 CGycm2 (standard deviation 33.42; range 160.4). Active monitoring and recording of fluoroscopy time and radiation dose with a compliance of greater than 95% lead to a statistically significant reduction in radiation exposure.