Peripherally inserted central catheters placed by a nurse-led vascular access team: Initial outcomes from a prospective single-center study
Bartosz Sadownik, Maciej Latos, Artur Szymczak, Marceli Solecki, Łukasz Wróblewski, Gabriela Świętochowska-Tauz, Mateusz Zawadka, Aleksandra Święch-Zarzycka, Marta Jurkiewicz, Natalia Sak-Dankosky, Paweł Andruszkiewicz, Dariusz KossonBackground:
In many healthcare systems, PICCs are inserted by nurses working within dedicated vascular access teams (VAT). Evidence indicates that nurse-led VAT models achieve high technical success and acceptable complication rates when supported by standardized ultrasound-guided pathways. Despite this evidence, implementation remains inconsistent across Europe. This is the first prospective observational study in Poland evaluating nurse-led PICC insertion within a VAT model.
Methods:
The study evaluated outcomes of a nurse-led PICC insertion pathway implemented within a hospital VAT. The primary endpoint was first-attempt venipuncture success; overall technical success was an additional outcome. Secondary endpoints included tip position, catheter-related complications, and catheter function. Adult patients (⩾18 years) requiring central vascular access and able to provide written informed consent were eligible. PICCs were inserted by VAT nurses trained in ultrasound-guided vascular access, each with at least 4 years of experience and more than 500 successful midline catheter insertions. Procedures were performed under physician oversight required by the Polish legal, institutional, and bioethics framework.
Results:
During the study period, 127 patients underwent attempted PICC insertion. Ten were not enrolled because they could not provide written informed consent, leaving 117 patients for analysis. First-attempt venipuncture was achieved in 109 procedures (93.2%; 95% CI, 87.1–96.5%), while two attempts were required in eight cases (6.8%). PICC insertion was technically successful in 112 cases (95.7%). In 79 patients (67.5%), VAT assessment resulted in PICC placement instead of the planned CICC. Full catheter patency was maintained in 110 of 112 PICCs (98.2%). Premature removal due to catheter-related complications occurred in 16 cases (14.29%; 95% CI, 7.80–20.77%).
Conclusions:
A nurse-led PICC insertion pathway embedded within a VAT can be implemented safely and effectively in Poland. High procedural success, sustained catheter patency, and frequent avoidance of planned CICC placement indicate potential clinical and organizational benefits.
Clinical Trials:
PICC Inserted by a Nurse-led Vascular Access Team in Poland (NIce-PICC; NCT06979128)