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CONTROL ID: 1566474 TITLE: HOSPITALIST EXPERIENCES, PRACTICE, OPINIONS AND KNOWLEDGE RELATED TO PERIPHERALLY INSERTED CENTRAL CATHETERS: A MICHIGAN SURVEY CHAIR/PRESENTER INFORMATION: Name: Dr.Vineet Chopra, MD, MSc, Assistant Professor Affiliation: Patient Safety Enhancement Program and Center for Clinical Management Research, Ann Arbor VA Medical Center, Ann Arbor, MI, United States; Affiliation: Dept of General Internal Medicine, University of Michigan, Ann Arbor, MI, United States; Address 1: 3119 Taubman Health Center Address 2: (none) City: Ann Arbor State: MI Postal Code/Zip: 48109 Country: United States Phone: 7346471599 Fax: (none) E-mail:
[email protected] SHM Member Number: No ************************************************* Name: Dr.Charles E. Coffey, MD, MSc Affiliation: Department of Medicine, Henry Ford Health System, West Bloodfield, MI, United States; Address 1: Henry Ford Health System Address 2: (none) City: West Bloomfield State: MI Postal Code/Zip: 48322 Country: United States Phone: 7346471599 Fax: (none) E-mail:
[email protected] SHM Member Number: No ************************************************* Name: Dr.James Barron, MD Affiliation: Department of Medicine, Spectrum Healthcare System, Grand Rapids, MI, United States; Address 1: Spectrum Healthcare System Address 2: (none) City: Grand Rapids State: MI Postal Code/Zip: 49503 Country: United States Phone: 7346471599
Fax: (none) E-mail:
[email protected] SHM Member Number: No ************************************************* Name: Dr.Mohammad Salameh, MD Affiliation: Department of Medicine, St. Josephs Mercy Health System, Ypsilanti, MI, United States; Address 1: St. Josephs Healthcare System Address 2: (none) City: Ypsilanti State: MI Postal Code/Zip: 48104 Country: United States Phone: 7346471599 Fax: (none) E-mail:
[email protected] SHM Member Number: No ************************************************* Name: Dr.Sarah Krein, PhD Affiliation: Patient Safety Enhancement Program and Center for Clinical Management Research, Ann Arbor VA Medical Center, Ann Arbor, MI, United States; Affiliation: Dept of General Internal Medicine, University of Michigan, Ann Arbor, MI, United States; Address 1: 3119 Taubman Health Center Address 2: (none) City: Ann Arbor State: MI Postal Code/Zip: 48109 Country: United States Phone: 7346471599 Fax: (none) E-mail:
[email protected] SHM Member Number: No ************************************************* Name: Dr.Scott A. Flanders, MD Affiliation: Dept of General Internal Medicine, University of Michigan, Ann Arbor, MI, United States; Address 1: 3119 Taubman Center Address 2: (none) City: Ann Arbor State: MI Postal Code/Zip: 48109 Country: United States Phone: 7346471599 Fax: (none) E-mail:
[email protected] SHM Member Number: No ************************************************* Name: Dr.Sanjay Saint, MD, MPH Affiliation: Patient Safety Enhancement Program and Center for Clinical Management Research, Ann Arbor VA Medical Center, Ann Arbor, MI, United States; Affiliation: Dept of General Internal Medicine, University of Michigan, Ann Arbor, MI, United States;
Address 1: 3119 Taubman Center Address 2: (none) City: Ann Arbor State: MI Postal Code/Zip: 48109 Country: United States Phone: 7346471599 Fax: (none) E-mail:
[email protected] SHM Member Number: No ABSTRACT BODY: Background: Peripherally inserted central catheters (PICCs) are commonly inserted/ordered by hospitalists for venous access, long term therapies and infusion of TPN, Despite these salient roles, little is known about PICC use in hospitalized patients. T To understand hospitalist practice related to PICC, a web-based survey of a convenience sample of hospitalists in 4 healthcare systems across Michigan was designed. Methods : We conducted an online survey to assess hospitalist experience, practice, opinions and knowledge related to PICCs. A convenience sample of hospitalists (N=227) was obtained from 4 large healthcare systems that participate in the Hospital Medicine Safety (HMS) Consortium, a Blue Cross/Blue Shield of Michigan-funded collaborative quality initiative. Individuals engaged in research, quality improvement or leadership at HMS sites were invited to serve as site principal investigators (PIs). Participation in the survey was solicited via email invitations from site PIs to hospitalists within their group. As an incentive to increase participation, a $10.00 electronic gift card was offered to respondents who successfully completed the survey. The survey was made available for five weeks to maximize recruitment for the study and all responses were collected anonymously. Results : The overall response rate was 63% (N=144). Compared to central venous catheters, hospitalists felt that PICCs were safer to insert (81%) and preferred by patients (74%). Although 84% of respondents felt that placing a PICC solely to obtain venous access was appropriate, 47% of hospitalists indicated that 10-25% of PICCs inserted in their hospitals might represent inappropriate placement. Hospitalist knowledge regarding PICC-related complications was poor for PICC-related venous thromboembolism. For instance, only 4% of hospitalists recognized that PICC-tip verification was important to preventing thrombosis. Furthermore, hospitalist practice related to PICCs demonstrated several concerns. For example, 1 in 3 hospitalists stated they never examine PICCs for externally evident problems such as exit-site infection; the majority of surveyed hospitalists (48%) stated that once a PICC was inserted, they did not remove it until a patient was ready for discharge, and 51% admitted that, at least once, they had “forgotten” that their patient had a PICC. Conclusions : Significant variation in hospitalist experiences, practice, opinion and knowledge related to PICCs exists. Because these devices are often associated with important complications, studies examining impact of this variation are necessary. Till such evidence is available, health systems should consider developing mechanisms to monitor PICC use. TABLE TITLE: (No Tables) (No Table Selected) TABLE FOOTER: (No Tables)
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