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Eliminating the guesswork

Presence Saint Joseph is first in state with new technology to increase PICC accuracy

JOLIET, Ill. — Presence Saint Joseph Medical Center has become the first hospital in the state of Illinois to acquire new technology that allows for more accurate placement of peripherally inserted central catheter (PICC) and reduces radiation exposure for the patients who need the catheter.

A PICC is a thin, flexible hollow tube that is inserted into a vein of the upper arm to deliver medications to the bloodstream and draw blood.

The tip of the catheter must be precisely placed in the correct location to avoid serious complications such as arterial placement or inadvertent placement in the wrong vein. Proper placement increases safety and reduces the risk of complications.

Traditionally after a PICC is placed, a chest X-ray is taken to confirm the optimal tip placement. Sometimes, the X-ray reveals an improper placement, meaning the entire process may need to be repeated, which causes a delay in care.

Saint Joe’s Vascular Access Coordinator Connie Girgenti, RN, VA-BC, felt there had to be a better way.
She read a study conducted by Georgetown University Hospital about a new technology called the VasoNova™ Vascular Positioning System (VPS).

VPS uses a combination of intravascular Doppler ultrasound, EKG and an algorithm to provide the clinician with precise, real-time navigation as the catheter is being placed.

“It’s like seeing inside the chest,” Girgenti says.

The Georgetown study found that when VPS was used for patients with a normal sinus rhythm (heartbeat), a follow-up chest x-ray was not necessary. But to be absolutely sure that the VPS system was the right choice for her patients, Girgenti conducted her own Internal Review Board-approved study to put the Georgetown findings to the test.

Her research confirmed what the Georgetown study said; VPS eliminated the need for a chest X-ray after PICC placement in patients with normal sinus rhythm. Another advantage is that VPS can be used with some patients with an absent p-wave, as in Atrial fibrillation.

“It’s empowering because it takes away the guesswork and you know the tip is exactly where it’s supposed to be,” says Girgenti. “It’s changing the way we practice.

“The nurses are happy because they can start using the PICC right away instead of waiting for the chest X-ray to be taken and the results to be read and dictated.”

Girgenti has submitted a poster of her research to The Association for Vascular Access, which will be presented at the association’s national conference in September.

She’s also working with Saint Joe’s leadership to start using the system for the placement of central venous catheters, or central lines.

Other Presence Health ministries are looking into the same technology.

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