Abstract
Purpose: The purpose of this project was to determine if revising the algorithm of extended dwell catheters (EDPIC) decrease central lines rates. The project evaluated outcomes post-implementation of EDPIC revised algorithm use.|Background: Vascular access is the cornerstone for patients to receive medical treatment in the acute care setting. Patients with difficult intravenous access attempts may be inappropriately receiving central access. EDPICs may provide a successful alternative to central lines.|Sample/Setting: The project was set in two inpatient units at a large academic teaching hospital. 182 subjects met criteria out of a sample size of 2391 between medicine and cardiology inpatient units.|Methods: Evaluation of the current algorithm was re-evaluated and a newly revised algorithm for appropriate use of the extended dwell catheter was written. Development and implementation of a revised algorithm for EDPIC on two adult inpatient units at a large academic hospital eight weeks baseline and eight weeks post implementation The outcomes of this project were evaluated by central line device utilization rates, central line bloodstream infection rates, and EDPIC device utilization rates.|Results: Central line utilization rates at baseline were (43/92) 47% and (6/90) 7% in post implementation data. Post-implementation data demonstrated significant decrease in non-medically necessary central lines compared to baseline data (χ2 (1) = 38.97, p < .001). EDPIC rates at baseline were (49/92) 53% and increased to (84/90) 93 %. EDPIC rates demonstrates a significant increase in post implementation period (χ2 (1) = 35.94, p < .001). CLABSI rates did not significantly decrease in post-implementation compared to baseline.|Conclusion: Implementing a revised algorithm for EDPIC significantly decreased central line utilization rates and increased EDPIC utilization rates. CLABSI rates did not decrease but providing an algorithm and alternative to central intravenous lines significantly decreased non-medically indicated central lines.
Keywords: Extended dwell peripheral catheter, long peripheral catheter, difficult intravenous access