Impacts Of Evidence-based Practice For Improving Quality On Complications Of The Peripherally Inserted Central Catheter In Neonates

Objective:To evaluate a evidence-based practice for improving Quality（EPIQ）program to decrease complications of Peripherally Inserted Central Catheter（PICC）in neonates.Methods:The retrospective cohort study included neonates weighing no less than 2000g at birth who were admitted to Department of Neonatology,Children’s Hospital of Chongqing Medical University,and inserted PICC between 2016 and 2019.A PICC improving program was introduced to reduce PICC associated complications.A multifaceted PICC management was concluded.Results:A total of 1376 neonates were enrolled.While the central line utilization ratio increased[68.78%（1897/2758）,75.78%（2444/3225）, 76.15%（4568/5999）,74.77%（4960/6634）;χ²_trend=21.690,P<0.001]from2016 to 2019,non-infection complications decreased[23.26%（40/164）,9.57%（22/230）,5.19%（24/462）,4.69%（24/512）;χ²_trend=50.789,P<0.001].And the Catheter-line associated bloodstream infections（CLABSI） incidence fluctuated at a low level(0-1.53/1000 catheter day,χ²_trend=1.077,P=0.299).The age（OR=1.025,95%CI:1.003-1.048,P=0.024）and site（P<0.001）of insertion were risk factors of non-infection complications.Compared with the upper extremity PICCs,the scalp PICCs（OR=0.337, 95%CI:0.216-0.528,P<0.001）were associated with lower complications.Conclusion:Complications of PICC was successfully decreased in neonates whose birthweight≥2000g.