United Hospital Fund (UHF) today released a detailed guide for home care patients and their family caregivers that explains in straightforward text and graphics how to safely maintain a peripherally inserted central catheter, familiarly known as a PICC line—an intravenous line used to administer fluids, blood products, medications, and chemotherapy.
The new guide was developed in response to a survey of the needs of patients and family caregivers, who are increasingly taking on complex medical tasks at home. It fills an important resource void, and is designed to supplement personal instruction and guidance by home health nursing professionals.
The second product of a collaboration between United Hospital Fund and two grant recipients, Montefiore Health System and Northwell Health, the guide is a follow-up to a toolkit for home health professionals. It advances UHF’s broad-ranging work to improve patient care and safety in both the inpatient and outpatient settings, with a particular focus on preventing infections and avoidable hospitalizations.
“We expect that this guide will help family caregivers and patients manage one of their most difficult home care challenges,” said Deborah Halper, vice president, Education and Program Initiatives, at UHF. “It can be customized to meet the needs of individual health care providers as they work with patients and family caregivers to help them understand, follow, and carry out instructions to care for a central line.”
A PICC or central line is inserted through the skin into a vein that typically terminates at or near the heart; dangerous bloodstream infections can develop if these lines are not properly maintained. A substantial number of patients are discharged from hospital to home with PICC lines in place; however, patients and family caregivers often do not have the training or access to easy-to-understand resources to safely maintain the lines.
The new guide provides information on the use of a PICC, how to detect early signs of infection, and when to notify the patient’s health care provider. It also includes details on how to change the site dressing and protect the site from moisture while showering.
“More and more patients are discharged with intravenous access devices and with only intermittent care from a home health care nurse; the remainder of the time the patient must provide self-care or rely on a family caregiver,” said Donna Armellino, RN, DNP, CIC, vice president for infection control at Northwell Health. “PICC line care is complicated and the negative consequences of infections are a continued threat as long as the device is in place. This guide helps promote uniform care within the home care setting, regardless of who is maintaining the PICC.”
“This addendum to the toolkit will provide patients and family caregivers with additional education to ease any apprehension regarding the care and maintenance of PICC lines,” said Audrey Adams, RN, MPH, CIC, director of Infection Prevention and Control at Montefiore Health System. “It is our hope that these documents will contribute to the infection prevention/patient safety resources available to staff and patients in the home care setting.”
The new guide, Caring for Your Peripherally Inserted Central Catheter (PICC): A Guide for Patients and Family Caregivers, is free and can be downloaded from the UHF website. It is meant to be used along with personal instruction and guidance from a home care nurse, who can print out and discuss the resource, go through insertion and maintenance step by step, answer any questions, and refer to the guide on subsequent visits.
The guide is divided into a number of sections, including:
- general information on what a PICC line is and its purpose;
- reminders of the patient’s specific PICC and treatment requirements;
- the basics of caring for a PICC line, including warning signs of complications;
- how to protect a PICC line when showering and during other activities;
- flushing PICC lines, with or without giving medication;
- appendix that details the steps involved in changing the PICC line dressing.
Patients and caregivers can follow and use all of the components of the guide, or can pull and post the sections that are most relevant to them.
The earlier UHF/Montefiore/Northwell toolkit, released in 2016, provides a number of resources to help home care and hospital providers assess the risk for central line infections in patients receiving home health care services, reduce the incidence of infection, and promote more effective communication. Preventing Central Line-Associated Bloodstream Infection (CLABSI) in the Home Care Setting is also available free of charge on the UHF website.
About United Hospital Fund
United Hospital Fund works to build a more effective health care system for every New Yorker. An independent, nonprofit organization, we analyze public policy to inform decision-makers, find common ground among diverse stakeholders, and develop and support innovative programs that improve the quality, accessibility, affordability, and experience of patient care. For more on our initiatives and programs please visit our website at www.uhfnyc.org and follow us on Twitter.
About Northwell Health
Northwell Health is New York State’s largest health care provider and private employer, with 21 hospitals and over 550 outpatient facilities. We care for more than two million people annually in the metro New York area and beyond, thanks to philanthropic support from our communities. Our 61,000 employees – 15,000+ nurses and nearly 3,400 physicians, including nearly 2,700 members of Northwell Health Physician Partners – are working to change health care for the better. We’re making breakthroughs in medicine at the Feinstein Institute. We're training the next generation of medical professionals at the visionary Hofstra Northwell School of Medicine and the School of Graduate Nursing and Physician Assistant Studies. And we offer health insurance through CareConnect. For information on our more than 100 medical specialties, visit Northwell.edu.
About Montefiore Health System
Montefiore Health System is one of New York’s premier academic health systems and is a recognized leader in providing exceptional quality and personalized, accountable care to approximately three million people in communities across the Bronx, Westchester, and the Hudson Valley. It is comprised of 10 hospitals, including the Children’s Hospital at Montefiore, Burke Rehabilitation Hospital, and close to 200 outpatient care sites. The advanced clinical and translational research at its medical school, Albert Einstein College of Medicine, directly informs patient care and improves outcomes. From the Montefiore-Einstein Centers of Excellence in cancer, cardiology and vascular care, pediatrics, and transplantation, to its preeminent school-based health program, Montefiore is a fully integrated health care delivery system providing coordinated, comprehensive care to patients and their families. For more information please visit www.montefiore.org. Follow us on Twitter and view us on Facebook and YouTube.
Catherine Arnst, United Hospital Fund