Peripherally inserted central catheter (PICC) use in the acute care setting is representative of how novel technologies influence the care of hospitalized patients. As with other healthcare innovations, the use of PICCs began in a defined population to solve an important clinical problem. However, over time, PICC insertion has evolved to span other indications and patient populations. This diffusion has led to recognition that the known advantages associated with PICC use may be offset by risks, costs, and complications in particular instances. Identifying and balancing the risks and benefits related to PICCs is thus critical to ensuring patient safety. The long-term goal of this career development award is to promote the candidates' development into an independently funded physician-scientist with expertise in prevention of hospital- acquired complications. Using PICCs as a model for this work, this project aims to: 1) develop appropriateness criteria to guide use of PICCs in hospitalized patients; 2) identify and assess predictors of PICC-complications; 3) lay the foundation for translating this research into practice. Successful completion of this work will substantially impact patient care and ensure the candidates future success through acquisition of critical skills and content expertise in prevention of hospital-acquired complications. The candidate will pursue a mentored research plan that will promote development of expertise in: 1) hospital epidemiology, vascular biology, and infection prevention; 2) analysis of longitudinal, categorical, and survival data; 3) decision-making, leadership and cost- effectiveness; and 4) implementation science. The career development plan consists of a multidisciplinary team of experienced mentors and advisors who will oversee a range of formal coursework and practical experiences to ensure the candidates' success. Exceptional resources and a mentoring team with proven success in developing junior physician-scientists make the University of Michigan an ideal environment for this proposal.

Public Health Relevance

Peripherally inserted central catheters have rapidly become the most common central venous catheters inserted in hospitalized patients. As their use has grown, so too has the evidence suggesting that they are associated with risks and complications. This research will generate an evidence-based set of criteria to define appropriate indications for PICC use in hospitalized patients and identify predictors of PICC-related complications. This knowledge will be used to develop and design interventions to improve the safety of PICCs in hospitalized patients.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Clinical Investigator Award (CIA) (K08)
Project #
5K08HS022835-04
Application #
9211328
Study Section
HSR Health Care Research Training SS (HCRT)
Program Officer
Willis, Tamara
Project Start
2014-04-01
Project End
2018-03-31
Budget Start
2017-04-01
Budget End
2018-03-31
Support Year
4
Fiscal Year
2017
Total Cost
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Sinha, Shashank S; Prabhakaran, Dorairaj; Chopra, Vineet (2017) Confluence of Cultural Context and Technological Innovation to Reduce Cardiovascular Disparities in India. Circ Cardiovasc Qual Outcomes 10:
Rickard, Claire M; Marsh, Nicole M; Webster, Joan et al. (2017) Peripherally InSerted CEntral catheter dressing and securement in patients with cancer: the PISCES trial. Protocol for a 2x2 factorial, superiority randomised controlled trial. BMJ Open 7:e015291
Mimoz, Olivier; Chopra, Vineet; Widmer, Andreas (2016) What's new in skin antisepsis for short-term intravascular catheters: new data to address old problems? Intensive Care Med 42:2043-2045
McMahon Jr, Laurence F; Tipirneni, Renuka; Chopra, Vineet (2016) Health System Loyalty Programs: An Innovation in Customer Care and Service. JAMA 315:863-4
Moureau, Nancy; Chopra, Vineet (2016) Indications for peripheral, midline and central catheters: summary of the MAGIC recommendations. Br J Nurs 25:S15-24
Chopra, Vineet; Smith, Shawna; Swaminathan, Lakshmi et al. (2016) Variations in Peripherally Inserted Central Catheter Use and Outcomes in Michigan Hospitals. JAMA Intern Med 176:548-51
Harrod, Molly; Montoya, Ana; Mody, Lona et al. (2016) Challenges for Nurses Caring for Individuals with Peripherally Inserted Central Catheters in Skilled Nursing Facilities. J Am Geriatr Soc 64:2059-2064
Grant, Paul J; Greene, M Todd; Chopra, Vineet et al. (2016) Assessing the Caprini Score for Risk Assessment of Venous Thromboembolism in Hospitalized Medical Patients. Am J Med 129:528-535
Chopra, Vineet; Flanders, Scott A; Saint, Sanjay et al. (2015) The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC): Results From a Multispecialty Panel Using the RAND/UCLA Appropriateness Method. Ann Intern Med 163:S1-40
Fallouh, Nabil; McGuirk, Helen M; Flanders, Scott A et al. (2015) Peripherally Inserted Central Catheter-associated Deep Vein Thrombosis: A Narrative Review. Am J Med 128:722-38

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