Improved Care and Reduced Costs for Patients Requiring Peripherally Inserted Central Catheters (PICC)

2.50
Hdl Handle:
http://hdl.handle.net/10755/162420
Type:
Presentation
Title:
Improved Care and Reduced Costs for Patients Requiring Peripherally Inserted Central Catheters (PICC)
Abstract:
Improved Care and Reduced Costs for Patients Requiring Peripherally Inserted Central Catheters (PICC)
Conference Sponsor:Emergency Nurses Association
Conference Year:2011
Author:Bautista, Elenita, RN, BSN, ONC
P.I. Institution Name:Ben Taub General Hospital Trauma Services
Title:Trauma Outcome Manager
Contact Address:1504 Taub Loop, Houston, TX, 77030, USA
Contact Telephone:713-873-3443
Co-Authors:Robin Garza, RN, MSN; Steve Peardon, RN, MBA/HCM
[ENA Leadership Conference] Evidence-based Practice Presentation: Improved Care and Reduced Costs for Patients Requiring Peripherally Inserted Central Catheters (PICC)

Purpose: The purpose of this project was to identify methods to improve care, reduce waiting time and reduce the costs associated with intravenous access for intermediate to long term use in the trauma patient.

Design: This was a retrospective study.

Setting: This study was conducted in an urban Level I Trauma Center.

Sample: Medical records of all patients admitted during the month of July to August, 2007 who had an order for PICC line insertion were evaluated. Trauma Services has a registry/data base and is protected by the regulations of the department and its institutional policy of research/research proposal.

Methods: The identified records were examined for total cost, waiting time from order to insertion, length of stay and associated complications. Prior to and during the time of this study, PICC line insertions were being completed in Interventional Radiology by Radiologist. It was identified that there were often delays in the procedure secondary scheduling conflicts. The result of this delay also presented a delay in implementing care as well as increased apprehension for patients and extended length of stay. Results were tabulated and presented to the Trauma Program and Performance Improvement Committee for review and recommendation.

Result/Outcomes: The recommendation was implementation of a Nursing PICC team and a team was formulated under the supervision of the Emergency Department Director. Required equipment was purchased, policies created and approved and the PICC team launched nurse inserted PICC lines. The PICC team has achieved and maintained greater than 90% accuracy in the 1st quarter of implementation: April 2008 = 92.31%, May 2008 = 98.21%, June 2008 = 96.88%. The majority of PICCs are placed the same day as the order. Exception- orders placed on Saturday or Sunday.
Infusion therapies can be started earlier which in turn decreases LOS, decreasing the number of unnecessary hospital days. Patients are able to be discharged on the same day or next day after PICC placed. IV Team for PICC insertion increased patient satisfaction because it is performed at bedside, prompt service, earlier discharge. It also increase staff satisfaction as therapy can be started or continued without interruption, blood specimens can be readily obtained, no need for repeated sticks to obtain access. Physician satisfaction increased as well because of prompt service, prompt administration of therapy, and central venous access without need for CVC. The cost analysis of PICC line placement by discipline revealed an estimated 65% decrease in total associated cost from physician led placement to a RN PICC team.

Conclusions: A team of registered nurses certified to perform the tasks provides an equal or better performance of task and resulted in favorable outcomes not only to patients but to healthcare providers and the healthcare system as well. It is imperative that a nursing leader be consistent and persistent in a having a project become a reality for a cause & cost. It has been a year since implementation and the cost of insertion has decreased by 25% from service inception. The PICC team is now inserting an average of 220 lines monthly.

Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleImproved Care and Reduced Costs for Patients Requiring Peripherally Inserted Central Catheters (PICC)en_GB
dc.identifier.urihttp://hdl.handle.net/10755/162420-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Improved Care and Reduced Costs for Patients Requiring Peripherally Inserted Central Catheters (PICC)</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2011</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Bautista, Elenita, RN, BSN, ONC</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Ben Taub General Hospital Trauma Services</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Trauma Outcome Manager</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1504 Taub Loop, Houston, TX, 77030, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">713-873-3443</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">elenita_bautista@hchd.tmc.edu; elenita_bautista@sb</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Robin Garza, RN, MSN; Steve Peardon, RN, MBA/HCM</td></tr><tr><td colspan="2" class="item-abstract">[ENA Leadership Conference] Evidence-based Practice Presentation: Improved Care and Reduced Costs for Patients Requiring Peripherally Inserted Central Catheters (PICC)<br/><br/>Purpose: The purpose of this project was to identify methods to improve care, reduce waiting time and reduce the costs associated with intravenous access for intermediate to long term use in the trauma patient.<br/><br/>Design: This was a retrospective study. <br/><br/>Setting: This study was conducted in an urban Level I Trauma Center.<br/><br/>Sample: Medical records of all patients admitted during the month of July to August, 2007 who had an order for PICC line insertion were evaluated. Trauma Services has a registry/data base and is protected by the regulations of the department and its institutional policy of research/research proposal.<br/><br/>Methods: The identified records were examined for total cost, waiting time from order to insertion, length of stay and associated complications. Prior to and during the time of this study, PICC line insertions were being completed in Interventional Radiology by Radiologist. It was identified that there were often delays in the procedure secondary scheduling conflicts. The result of this delay also presented a delay in implementing care as well as increased apprehension for patients and extended length of stay. Results were tabulated and presented to the Trauma Program and Performance Improvement Committee for review and recommendation.<br/><br/>Result/Outcomes: The recommendation was implementation of a Nursing PICC team and a team was formulated under the supervision of the Emergency Department Director. Required equipment was purchased, policies created and approved and the PICC team launched nurse inserted PICC lines. The PICC team has achieved and maintained greater than 90% accuracy in the 1st quarter of implementation: April 2008 = 92.31%, May 2008 = 98.21%, June 2008 = 96.88%. The majority of PICCs are placed the same day as the order. Exception- orders placed on Saturday or Sunday.<br/>Infusion therapies can be started earlier which in turn decreases LOS, decreasing the number of unnecessary hospital days. Patients are able to be discharged on the same day or next day after PICC placed. IV Team for PICC insertion increased patient satisfaction because it is performed at bedside, prompt service, earlier discharge. It also increase staff satisfaction as therapy can be started or continued without interruption, blood specimens can be readily obtained, no need for repeated sticks to obtain access. Physician satisfaction increased as well because of prompt service, prompt administration of therapy, and central venous access without need for CVC. The cost analysis of PICC line placement by discipline revealed an estimated 65% decrease in total associated cost from physician led placement to a RN PICC team. <br/><br/>Conclusions: A team of registered nurses certified to perform the tasks provides an equal or better performance of task and resulted in favorable outcomes not only to patients but to healthcare providers and the healthcare system as well. It is imperative that a nursing leader be consistent and persistent in a having a project become a reality for a cause &amp; cost. It has been a year since implementation and the cost of insertion has decreased by 25% from service inception. The PICC team is now inserting an average of 220 lines monthly.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:27:55Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:27:55Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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