Preventing PICC-related complications among pediatric patients
Abstract:
Background: Prolonged peripherally inserted central catheter (PICC) use in pediatric patients with hematologic disorders is associated with an elevated risk of central line-associated bloodstream infection (CLABSI), which can lead to poor outcomes and a mortality rate approaching 25%.
Objective: To evaluate the effectiveness of the PICC-Quality Management System (QMS) in reducing CLABSI and PICC-related complications in pediatric hematologic patients.
Methods: We conducted a single-center, pre-post intervention study including pediatric patients with PICC placement exceeding 48 hours. The 2023 cohort (n = 611) received conventional care, whereas the 2024 cohort (n = 693) received care under the PICC-QMS. Baseline demographics and clinical characteristics were comparable between groups.
Results: A total of 1304 patients (mean age ± SD, 9.22 ± 0.11 years; 34.7% female) were analyzed. Compared with conventional care, PICC-QMS implementation was associated with lower CLABSI incidence (22 versus 13 cases; P = .06) and reduced thrombus formation (6 versus 1 case; P = .039). After adjustment for ward type, logistic regression indicated a significantly reduced CLABSI risk in the PICC-QMS group (adjusted odds ratio, 0.46; 95% CI, 0.20-0.90; P = .022).
Conclusions: The PICC-QMS effectively reduces CLABSI incidence in pediatric patients with hematologic disorders, underscoring its value as an infection control strategy.
Implications for oncology nursing practice: Standardization, refinement, and continuous monitoring under the PICC-QMS provide a practical, reproducible framework for integrating high-quality PICC care into routine practice, offering a potential reference model for other high-risk populations.
Reference:
Yu B, Tang X, Zhang B, Chen J, Zhou S, Zhou F, Xiang L, Shen N, Hong L. Effect of a Quality Management System on Preventing Peripherally Inserted Central Catheter-Related Complications Among Pediatric Patients With Hematology Disorders. Cancer Nurs. 2026 Jun 23. doi: 10.1097/NCC.0000000000001585. Epub ahead of print. PMID: 42319818.