PROJECT 

Implementation of a Radiographer PICC Insertion Service

 

TEAM:

Gillian Lumley, Clinical Specialist Radiographer Interventional Radiology;

Paul McNally, Senior Radiographer;

Louise Diamond, Radiography Services Manager3;

Dr. Anthony Cullen, Clinical Director Diagnostics Directorate, Interventional Consultant Radiologist;

Prof. Anthony Ryan, Interventional Consultant Radiologist;

Dr. Ian Crosbie, Consultant Radiologist;

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LOCATION:

Radiology Department, University Hospital Waterford

 

THE PROBLEM:

Interventional Radiologists perform PICC insertions for the following patient cohorts (patients requiring long term antibiotics, Total Parenteral Nutrition and difficult IV access). There are an increasing number of patients require this service n=6 in 2011 – n=289 in 2022. PICC lines procedures are traditionally performed by Consultant Interventional Radiologists. By implementing a Radiographer led service our aim was to improve inpatient’s access and reduce waiting times for these procedures to reduce prolonged hospital stays.

 

THE SOLUTION:

• Set up a radiographer PICC insertion training program

• Train radiographers to put in PICCs

• Move the service to Fluoroscopy room to ease pressure on the Interventional Radiology suite.

• Allow more space for clinically urgent cases in IR suite.

• Reduce patient waiting times for PICC procedures

• Reduce prolonged inpatient hospital stays

 

BENEFITS:

In the 12 months from June 2023 to June 2024, 334 PICC procedures were performed (an increase of 15% from 2022). 89 of these procedures were performed by IR radiographers on completion of the PICC insertion training.

Despite increased referrals, patient waiting times have already reduced. The average waiting times for the period June 2023 to June 2024 was reduced to 2.22 days, with substantial reductions anticipated in Q4 2024.

Structured scheduling of PICC procedures will be incorporated into the Radiology workflow from September 2024.

The fluoroscopy suite will be utilised to deliver the dedicated radiographer-led PICC insertion service, increasing capacity and availability of the IR suite for more complex procedures.

This will lead to reduced inpatient stays with patients able to continue their treatment through the OPAT service.

 

PROJECT CONTACT DETAILS:

Gillian Lumley CSR Interventional Radiology UHW

Email: Gillian.lumley@hse.ie