2nd Place
Impact of Practice Change on Outcome: PICC Implementation Program

Problem:
The numbers of consults for peripherally inserted central catheters (PICC) is rising dramatically due to prolonged intravenous antibiotic therapies and infusion of hypertonic solutions. Frequent occlusion of these lines is problematic and effects timely delivery of therapy.

Evidence
21 PICC lines were inserted over three months and 8 were occluded. The national average of occlusion is 7-25%. In addition, variations in practice are identified as contributing factors for catheter patency evidenced by questions regarding flushing: dilution, frequency, and volume.

Strategy
A plan of action consisting of: new PICC line, PICC course taught by a clinical expert, templates created to enhance documentation to reflect practice changes, in-services presented to in-patient staff on the care and maintenance of the PICCs.

Practice change
The goal for change in practice was to follow a standard of care throughout the organization resulting in a measured decrease in the number of complaints of problems with PICCs and an increase number of patient catheters.