Reducing peripherally inserted central catheters in the neonatal intensive care unit

Objective:our objective was to safely reduce the number of peripherally inserted central catheters (piccs) inserted in infants with umbilical venous catheter using quality improvement methods.study design:in a tertiary neonatal intensive care unit, a questionnaire designed to prompt critical thinking around the decision to place a picc, along with an updated standardized feeding guideline was introduced. picc insertion in 86 infants with umbilical venous catheter (pre intervention) with birth weight 1000–1500 g were compared with 115 infants (post intervention) using fisher’s exact test.results:picc lines inserted after the intervention decreased by 37.5% (67/86; 77.9% vs 56/115; 48.7%; p<0.001). the proportion of central line-associated blood stream infection were 2.49 vs 2.82/1000 umbilical venous catheter days; p=0.91 in the two epochs, respectively.conclusion:quality improvement methodology was successful in significantly reducing the number of piccs inserted without an increase in central line-associated blood stream infection.