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.
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.
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