Overutilization of Peripherally Inserted Central Venous Catheters in the Hospital Setting

Abstract

The purpose of this study was to assess the appropriate utilization of peripherally inserted central venous catheter (PICC) placement in patients in an urban hospital setting. We performed a retrospective review of a prospective database created for quality assurance purposes of all patients who had a PICC request placed on Friday afternoon–Sunday between January and June 2019. Data collected included demographic information, pertinent medical history, and procedural details (incidence of PICC placement and the reason for PICC cancellation). The most common reasons for PICC consultation was “long-term intravenous (IV) antibiotics” (51.3%) and “poor IV access” (39.5%). On retrospective chart review, only 51/76 (67%) patients underwent subsequent PICC placement in the days following request placement. Of the 1/3 patients in whom a PICC was not subsequently placed, 64% were deemed nonindicated, and an additional 28% were contraindicated. In these patients, the reason for PICC consultation was most commonly “poor IV access.” There appears to be an overutilization of PICCs in our hospital setting; indications for PICCs should be carefully reviewed as these lines pose a risk of morbidity to patients who may not need them.