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Variation in use of technology among vascular access specialists: an analysis of the PICC1 survey

Abstract

Background

While the use of technologies such as ultrasound and electrocardiographic (ECG) guidance systems to place peripherally inserted central catheters (PICCs) has grown, little is known about the clinicians who use these tools or their work settings.

Methods

Using data from a national survey of vascular access specialists, we identified technology users as PICC inserters that: (a) use ultrasound to find a suitable vein for catheter placement; (b) measure catheter-to-vein ratio; and (c) use ECG for PICC placement. Individual and organizational-level characteristics between technology users versus non-users were assessed. Bivariable comparisons were made using Chi-squared or Fisher’s exact tests; two-sided alpha with p<0.05 was considered statistically significant.

Results

Of the 2762 PICC inserters who accessed the survey, 1518 (55%) provided information regarding technology use. Technology users reported greater experience than non-technology users, with a higher percentage stating they had placed >1000 PICCs (55% vs. 45%, p<0.001). A significantly greater percentage of technology users also reported being certified in vascular access by an external agency than non-technology users (75% vs. 63%, p<0.001). Technology users were more often part of vascular access teams with ≥10 members compared to non-technology users (35% vs. 22%, p<0.001). Some practices also varied between the two groups: for example, use of certain securement devices and dressings differed between technology users and non-users (p<0.001).

Conclusions

Technology use by vascular access clinicians while placing PICCs is associated with clinician characteristics, work setting and practice factors. Understanding whether such differences influence clinical care or patient outcomes appears necessary.

J Vasc Access 2017; 18(3): 243 - 249

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/jva.5000711

Authors

Vineet Chopra, Latoya Kuhn, David Ratz, Suzanne Winter, Peter J. Carr, David Paje, Sarah L. Krein

Article History

Disclosures

Financial support: This project was funded by an Investigator Initiated Research Grant from the Blue Cross Blue Shield of Michigan Foundation (Grant Number 2140.II, PI: Chopra). The funding source played no role in study design, data acquisition, analysis or decision to report these data. Dr. Chopra is supported by a career development award from the Agency for Healthcare Research and Quality. This work was also supported by the Department of Veterans Affairs, Health Services Research and Development Service and National Center for Patient Safety. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the US government. Dr. Krein is supported by a VA Health Services Research and Development Research Career Scientist Award (RCS 11-222).
Conflicts of interest: Peter J. Carr has received “speakers’ bureau” payment from CareFusion in 2013 and Becton Dickinson in 2014 for lectures on vascular access. He received a grant from CareFusion to attend a scientific meeting and a part-funded Scholarship from Becton Dickinson to support research activities. All other authors declare no conflicts of interest.

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Authors

Affiliations

  • The Division of General Medicine, University of Michigan Health System, Ann Arbor, Michigan - USA
  • Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan - USA
  • Patient Safety Enhancement Program, VA Ann Arbor Healthcare System/University of Michigan, Ann Arbor, Michigan - USA
  • Division of Emergency Medicine, School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, Perth - Australia
  • Alliance for Vascular Access Teaching and Research Group, Menzies Health Institute Queensland, Griffith University, Brisbane - Australia

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