Root Cause Analysis and Nursing Quality Improvement for PICC Occlusion in an Elderly Critically Ill Patient

Abstract

Peripherally inserted central catheter (PICC) is widely used in clinical practice. It is mainly suitable for elderly critically ill patients who need long-term infusion of stimulating drugs (such as chemotherapeutic drugs), hypertonic drugs (such as fat emulsion, amino acids), and poor peripheral vascular conditions. Catheter blockage is one of the most common complications during its use, which may lead to treatment interruption, increased risk of infection, prolonged hospital stays, and affected patients' prognosis. In order to improve the quality of nursing care, the cause of PICC blockage in an elderly critically ill patient was analyzed by root cause analysis (RCA). The root cause analysis group was set up to find the near-end cause by time sequence method and the root cause by "5Why" method. Through cause mining, the supervision and assessment mechanism of PICC maintenance quality was re-established, the evaluation standard of PICC and the prevention strategy of blockage were standardized, and the system and process were improved to prevent similar incidents from happening again.