Establishing a Neonatal Peripherally Inserted Central Catheter (PICC) Team

Infants admitted to the neonatal intensive care unit (NICU) have a plethora of diagnoses, including prematurity and newborns with genetic, neurological, surgical, and cardiac problems. The nature of these disease processes usually precludes enteral feedings and providing the infant with appropriate nutrition and hydration is a priority. This requires central venous access and peripherally inserted central catheter (PICC) placement allows for a reliable route of administration for intravenous nutrition and medications. The purpose of this project was to develop a nurse-led neonatal PICC team to provide timely placement of PICC lines while maintaining cost-effectiveness and maintaining a minimal number of adverse events, such as central-line associated bloodstream infections (CLABSIs). A nurse-led neonatal PICC line team was created at one local Midwestern Level III NICU. Five-day shift and five-night shift NICU registered nurses (RNs) were recruited to join the neonatal PICC line team. This allowed the team to provide 24-hour PICC line coverage year-round. The initial qualifications for membership were 4+ years of Level III NICU experience, expert peripheral IV insertion skills, excellent communication and organizational skills, and flexibility of shift scheduling. Results showed a decrease in the length of time between PICC line consultation to successful PICC line placement and a decrease in the number of peripheral IV attempts between the time of PICC line consultation to successful PICC line placement without an increase in adverse patient events while maintaining cost-effectiveness. This project can be utilized among other nursing units to establish and maintain a successful PICC line team to improve patient outcomes without increasing cost or adverse patient events