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NSMC Improves Patient Safety with New PICC Placement Technology

NSMC's Salem Hospital is first in New England to use system


Long-time North Shore Medical Center (NSMC) IV therapy nurse Maureen Lawler, RN, couldn’t be more enthusiastic about the new electrocardiogram (EKG) guidance technology now being used at Salem Hospital to place Peripherally Inserted Central Catheters (PICCs).

Nurses using new system to insert PICC line
Salem Hospital IV therapy nurses Gail Koontz, RN, (left) and Nancy Sabogal, RN, with the new Sapiens PICC line guidance system.

“This is a major step forward in how we deliver care,” said Lawler, Clinical Leader of IV Therapy. “This new technology allows us to place a PICC line in a manner that is faster, safer and more cost-efficient than our previous method.”

NSMC's Salem Hospital, which went live with the new PICC system in November, is the first hospital in New England to employ this new technology. Union Hospital, also part of NSMC, will implement this new positioning method in coming months. NSMC is a member of Partners HealthCare.

“PICC lines are safe, reliable intravenous lines that allow patients to receive medication, blood products, nutrients, chemotherapy and other IV fluids essential to their treatment,” saiddd Kathy Jones, RN, Nurse Manager for IV Therapy. “They are placed in the arm using a local anesthetic and can remain in place for days, weeks and even months. These lines keep patients on schedule for their intravenous therapy and blood draws while avoiding the pain of multiple needle sticks that would ordinarily be necessary.”

Traditionally, a PICC line is inserted into a vein in a patient’s upper arm above the elbow and advanced across the chest until it reaches the Superior Vena Cava (SVC), one of the largest veins in the body, located above the heart. To ensure that the PICC line is positioned correctly, a chest X-ray has commonly been required--a step no longer required with the new technology.

The new Bard Sapiens Tip Confirmation System, as it is called, which has been used in Europe for more than a decade and increasingly in the United States, combines ultrasound for vein assessment and access, magnetic PICC tip tracking, and an electrocardiogram for final confirmation of location in the chest.

“Nurses can now ‘see’ the PICC line as it is inserted, receiving immediate and continuous feedback as it enters the SVC and is securely positioned,” explained Lawler.

“The data from the EKG reading is far superior to the traditional X-ray,” added Jones. “Now we know, right at the bedside, where the PICC line is located, eliminating the need for an X-ray and any delays associated with getting it processed and read by a radiologist.”

The new system also helps NSMC meet safety guidelines set by the Joint Commission around reducing X-ray exposures for both patients and clinicians.

Approximately 85 percent of the 800-plus annual PICC line insertions performed at Salem Hospital are expected to be done using the new Sapiens technology.


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