Background, Rationale and Suggested Implementation Strategies
- Create or share educational materials regarding the importance of lumens and risk of complications associated with central venous catheters, including PICCs.
- Consider implementing a strategy that defaults to use of single lumen PICCs unless an approved indication/rationale for placing a multi-lumen PICC exists
- If/when a double lumen or greater PICC is requested, ask clinical providers for justification regarding why a multi-lumen PICC is necessary
- Develop a list of criteria for when a multi-lumen PICC might be necessary. One such criteria is the Michigan “Less Lumens / Less Risk” criteria (link)
- Inserters placing PICCs should review justification for multi-lumen PICCs and make the final decision regarding the appropriate number of lumens in conjunction with ordering providers
- Include pharmacists for discussions regarding medication incompatibility to understand whether strategies such as spacing out medication administration or diluting medications to ensure safe peripheral infusion can be considered
- If a PICC is required for continued treatment in the outpatient setting, consider down-grading to single lumen device to reduce risk of complications
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