Ms Mari Takashima1, Ms Nicole Gavin2, Ms Emily Larsen1, Ms Sarah Northfield2, Mr Gabor Mihala1, Ms Amanda Corley2, Dr Marc Ziegenfuss Ziegenfuss2, Prof Claire Rickard1
1Griffith University, Spring Hill, Australia
2Queensland Health, , Australia
Central venous access devices (CVAD) provide vascular access for the majority of intensive care patients. However, currently no comprehensive registry for CVAD insertion, complications and failure exists for research and quality assessment purposes in Australia. The primary aim of this study was to examine the feasibility of a CVAD registry to measure peripherally inserted central catheter (PICC) outcomes.
In this feasibility study, Intensive Care Unit (ICU) patients undergoing PICC insertion within an Australian tertiary-referral hospital were included. Data was extracted from the electronic medical record (EMR) and post-ICU discharge from ward paper medical records until: removal of PICC removal, patient transfer to another hospital/facility, or death. The primary outcome was registry feasibility according to published criteria for national clinical quality registries. Secondary outcomes included PICC utilisation ratio; PICC numbers and days; details of patients and PICCs; reason for PICC removal; and PICC failure/1000 catheter days.
Three of seven feasibility criteria were not met: operational requirement, capturing necessary data, and infrastructure. Many patients were transferred to other wards, and the lack of an EMR in this setting meant 22% of PICCs were lost to follow up due to unavailable records. However, for insertion-only data, six of seven feasibility criteria were met, except for operational requirements, which could be solved by restructuring of the EMR.
A CVAD registry capturing data until PICC removal is only feasible if EMR is used throughout the hospital. The adoption of registry fields into the EMR will enable auto-population of a CVAD registry.
Emily Larsen has been a Senior Research Assistant with the Alliance for Vascular Access Teaching and Research (AVATAR) since 2013. In that time, she has managed single and multi-centre clinical studies (primarily randomised controlled trials). She is currently project managing the National Health and Medical Research Council funded ‘PISCES Trial’, exploring dressing and securement methods for Peripherally Inserted Central Catheters (PICCs) inserted within a Cancer Care Services cohort.