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HMS PICC Tier II Catheter Occlusion Toolkit

The Occlusion Tier II toolkit will introduce a series of tools aimed at quantifying and understanding why PICC occlusions occur, followed by targeted approaches to reduce this adverse event.

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  3. PICC Initiative
  4. HMS PICC Tier II Catheter Occlusion Toolkit
  5. Step 3: Review and Address Patient Factors

Step 3: Review and Address Patient Factors

Key institutional partners to engage in this step: Hospital Leadership, Providers, Interventional Radiology, Vascular Access Team

Elements:
  • Consider MAGIC to help inform decision of catheter choice in the ICU
    • ICU patients have greater rates of catheter occlusion than non-ICU patients
  • Train insertion staff to assess for risk of occlusion based on patient factors and ensure appropriate provider and device factors are taken into account prior to PICC insertion
    • Consider placing PICCs on the right side to reduce risk of occlusion if technically feasible, as PICCs placed in the left arm have a higher risk of occlusion
  • Educate patients regarding precautions they need to take while the PICC line is in place including no lifting heavy weights, no contact sports, avoid lifting the arm above your head, and monitoring the catheter length on the skin
  • Educate patients on PICC care
  • Evaluate when patients are being educated and ensure that education occurs at a minimum prior to/upon PICC insertion and upon discharge if the patient is being discharged with a PICC
Resources/Tools

For Providers:

For Patients:

Articles/References

Smith S, et al. Patterns and predicators of peripherally inserted central catheter occlusion:  The 3P-O Study. Journal of Vascular and Interventional Radiology 2017

  • Patient, Provider and Device Factors Associated with Catheter Occlusion
    • Patient- advanced age, elevated BMI, severe liver disease, diabetes, hemoglobin <10, ICU status