M21 - The ZIM method: study of complications associated with PICC insertion site selection

Abstract

Background: The ZIM method is a method to locate the ideal area for the insertion of PICC. This method detects a specific pattern of areas that offer a variety of risks and benefits for the insertion of the device and its management taking into account the characteristics of the musculo-skeletal tissue, skin and vessels. It has been conducted a longitudinal observational study of comparative complications developed following the implant of the PICC according to the ZIM method and by the traditional method. Does the choice of the PICC insertion site with the ZIM method reduce the incidence of catheter-related complications than the traditional method? By which percentage the PICC inserted without following the ZIM method are still positioned in the area of the arm considered ideal?Materials and methods: The sample was composed by 84 patients in which it has been placed a PICC between June 17th and November 4th 2014 at the Oncology of Novara. The patients was randomized in: Group 1: Zim method insertion (42) Group 2: Traditional method insertion (42) About patients belonging to Group 2, after the insertion it has still measured the point of insertion of the PICC in the arm, for to see in which area of the ZIM method it has been implantedResults: On 84 PICC placed 92.8% no complications ( 64 PICC in use, 5 removed and 9 patients are died) and the remaining 7.14% developed some complication.:Complications reported by the ZIM method insertion: Breaking the outer tract of the catheter, secondary dislodgement Complications reported by the traditional method insertions: Dislodgement, loop of the catheter, 2 breakages of the outer tract of the catheter, deep vein thrombosis This initial observation shows that the ZIM method is an optimal way to reduce the incidence of the post-insertion complications.Conclusions: Compared to the evaluation parameters established by Robert Dawson the Deep Vein Thrombosis is the only complication associated with the choice of the insertion site; other complications are associated with the device management, so only apparently the ZIM method can be considered valid. Although it hasn't verified the validity or not of the ZIM method, this study revealed three interesting data:-88% of PICC belonging to Group 2 have been placed in the green area according to guidelines of the ZIM method.-A good management of the device by the nurses is essential to prevent the development of late complications.-The ZIM method could be used for training. Background: The ZIM method is a method to locate the ideal area for the insertion of PICC. This method detects a specific pattern of areas that offer a variety of risks and benefits for the insertion of the device and its management taking into account the characteristics of the musculo-skeletal tissue, skin and vessels. It has been conducted a longitudinal observational study of comparative complications developed following the implant of the PICC according to the ZIM method and by the traditional method. Does the choice of the PICC insertion site with the ZIM method reduce the incidence of catheter-related complications than the traditional method? By which percentage the PICC inserted without following the ZIM method are still positioned in the area of the arm considered ideal? Materials and methods: The sample was composed by 84 patients in which it has been placed a PICC between June 17th and November 4th 2014 at the Oncology of Novara. The patients was randomized in: Group 1: Zim method insertion (42) Group 2: Traditional method insertion (42) About patients belonging to Group 2, after the insertion it has still measured the point of insertion of the PICC in the arm, for to see in which area of the ZIM method it has been implanted Results: On 84 PICC placed 92.8% no complications ( 64 PICC in use, 5 removed and 9 patients are died) and the remaining 7.14% developed some complication.: Complications reported by the ZIM method insertion: Breaking the outer tract of the catheter, secondary dislodgement Complications reported by the traditional method insertions: Dislodgement, loop of the catheter, 2 breakages of the outer tract of the catheter, deep vein thrombosis This initial observation shows that the ZIM method is an optimal way to reduce the incidence of the post-insertion complications. Conclusions: Compared to the evaluation parameters established by Robert Dawson the Deep Vein Thrombosis is the only complication associated with the choice of the insertion site; other complications are associated with the device management, so only apparently the ZIM method can be considered valid. Although it hasn't verified the validity or not of the ZIM method, this study revealed three interesting data:-88% of PICC belonging to Group 2 have been placed in the green area according to guidelines of the ZIM method.-A good management of the device by the nurses is essential to prevent the development of late complications.-The ZIM method could be used for training.