Insertion of a PICC line is a relatively routine procedure done on over 2.5 million patients globally per year. However, it can also lead to serious complications at a rate of 16.4% to 28.8% if the line is not inserted correctly. Post-insertion infections (PII) are common in patients who have PICC lines.
These infections occur within days or weeks of the IV insertion procedure. They result from the bacteria in the patient’s skin, blood, or other tissue getting into the tubing during the insertion of the PICC line.
Although PICC lines have revolutionized long-term intravenous access, they also come with a set of risks. This article will explore infections associated with PICC and preventive measures.
What are PICC Lines and Infections or Risks Associated with the Procedure
A PICC line is a catheter (tube) inserted into an arm vein and then threaded through the veins until it reaches the heart. It is used when you need antibiotics delivered directly into your bloodstream over a long period of time.
Some of those who may undergo this procedure are:
- Patients needing long-term IV therapy for conditions like cancer, infections, or digestive disorders.
- Patients receiving total parenteral nutrition (TPN) for malnourishment.
- Individuals for whom administering medications are too harsh or irritating for peripheral veins.
- Those with frequent blood draws or lab tests.
- Patients receiving hemodialysis for end-stage renal disease.
- Patients receiving antibiotics for sepsis or other severe infections.
- Individuals who need medications that cannot be given orally.
In instances where the treatment isn’t done correctly, the patient may suffer from the following:
1. Catheter-Related Bloodstream Infections (CRBSIs)
PICC lines are sources of serious bacterial infections known as catheter-related bloodstream infections. These infections are caused by bacteria called Staphylococcus aureus.
The common symptoms of CRBSIs are:
- Fever and chills
- Fatigue
- Pain or swelling in the arm where the catheter is inserted into the vein
If you experience any of these symptoms, contact your doctor immediately.
2. Deep Vein Thrombosis (DVT)
Deep vein thrombosis occurs when blood clots form in the deep veins of the body. DVT occurs in both arms or legs. This may lead to complications, such as pulmonary embolism, if it moves from its original location in the deep veins to smaller blood vessels in other parts of the body.
Symptoms include:
- Swelling
- Pain or tenderness in an arm or leg
- Warm skin overlying an area with DVT
- Red discoloration
- Discomfort when walking
3. Local Infections
Local infection occurs at the IV insertion site when a patient has not followed proper PICC line care instructions. These types of infections are rare and often caused by improper insertion techniques rather than poor hygiene practices.
Local infections resolve without medical intervention within two weeks. However, if they progress to sepsis or bacteremia, antibiotic therapy may be necessary to clear up the infection before it spreads and becomes life-threatening.
4. Occlusion
Occlusion refers to the obstruction of flow in an intravenous line. It is a common problem and is caused by multiple factors like kinking, clotting, or clogging of the tubing.
In the case of PICCs, occlusion can result in serious complications such as infection, thrombophlebitis, and vascular occlusion.
5. Other Risks Include:
- Bleeding
- Nerve injury
- Irregular heartbeat
- Damage to veins in your arm
Factors Contributing to Infection Rates
Factors contributing to the risk of IV insertion infections include:
1. Inadequate IV insertion Technique
A poorly inserted PICC line causes a number of complications (infection and thrombotic occlusion). Improper insertion techniques also cause the device to be misplaced or dislodged within the vein. This can lead to complications, such as venous thrombosis.
2. Poor Maintenance
The maintenance of PICC lines is vital for preventing infections. Suppose you don’t clean your PICC line properly; it becomes a breeding ground for bacteria and leads to infection.
3. Duration of Use
The longer you have a PICC line, the more likely you are to get an infection. It’s because the longer you have it, the more bacteria have time to build up on the tip of the catheter.
4. Patient Factors
Some people are more exposed to infection from their PICC lines than others because of the following:
- Weakened immune systems.
- People who take medicine suppress the immune system (called immunosuppressants).
- Children younger than five years old and adults older than 65 years old.
- Having other medical conditions such as diabetes, heart disease, cancer, and liver.
Prevention of IV Insertion Infections
Consider the following strategies:
Practice Proper IV Insertion Technique
The best way to prevent infection from PICC lines is to ensure medical professionals are well-trained in sterile techniques and follow strict guidelines during PICC line placement. But who can offer such quality education?
The National IV Association has it all! We’re the nation’s leading certifying body in the field of IV administration and education.
We’ve been helping healthcare professionals get through their IV certification exams by providing high-quality training and resources (comprehensive review courses). Our courses have helped thousands of people successfully pass their certification exams and become certified members of the National IV Association.
This course is designed to give you the knowledge and skills needed to succeed in your IV certification exam. Through our online platform, you’ll gain access to thousands of pages of resources to help you learn everything from how to safely insert an intravenous line to administer medication through an intravenous line.
You’ll also learn about the insertion of different types of needles into different parts of the body and how each type works best for specific purposes. So, please don’t hesitate to get in touch with us to get your IV certification today!
Other preventive measures are:
- Monitor duration of use. Assess the need for the PICC lines regularly and remove them as soon as they are no longer necessary.
- Address patient factors. Optimize patient health by managing underlying conditions and providing appropriate support for a healthy immune system.
Conclusion
Preventing post-insertion infections related to PICC lines is a vital aspect of patient care. By ensuring medical professionals receive proper training and IV certification (through the National I.V. Association’s Review Course), you will improve the sterile techniques practiced during PICC line placements.
In addition, investing in continuous education and training will not only lead to fewer complications but also contribute to a safer healthcare environment for patients and caregivers alike. Together, we can work towards minimizing the risks associated with PICC lines and strive for a healthier future for all.
