Repositioning techniques of malpositioned peripherally inserted central catheters

Authors

  • Jingfen Jin RN,

    Professor of Nursing and Director of Nursing Department
    1. The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, China
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  • Chunfang Chen RN,

    Advanced Practice Nurse, Corresponding author
    1. PICC Clinic, The Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China
    • The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, China
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  • Ruiyi Zhao RN,

    Head Nurse
    1. PICC Clinic, The Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China
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  • Aiping Li RN,

    Advanced Practice Nurse
    1. PICC Clinic, The Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China
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  • Yingqing Shentu RN,

    Advanced Practice Nurse
    1. PICC Clinic, The Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China
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  • Nan Jiang RN

    Advanced Practice Nurse
    1. PICC Clinic, The Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China
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Correspondence: Chunfang Chen, Advanced Practice Nurse, PICC Clinic, The Second Affiliated Hospital of Zhejiang University College of Medicine, No. 88 Jiefang Road, Hangzhou, Zhejiang Province, China. Telephone: +86 571 87784806. E-mail: 46158463@qq.com

Abstract

Aims and objectives

To describe potential repositioning techniques of malpositioned peripherally inserted central catheters.

Background

Various repositioning methods have been applied in clinical practice in managing malpositioned peripherally inserted central catheters, and many of them are proved effective. However, little publication reviewed on those literatures describing repositioning techniques to malpositioned peripherally inserted central catheters.

Design

Systematic review. The repositioning techniques were classified and concretely described according to different locations of malpositioned peripherally inserted central catheter tips.

Methods

Literature and relevant guidelines were reviewed, focusing on malpositioned locations and incidence, as well as repositioning skills to peripherally inserted central venous catheters. Six databases were searched, including MEDLINE, web of science, CINAHL, Cochrane library, Wanfang database and Chinese National Knowledge Infrastructure. The articles (n = 21) were analysed using inductive content analysis.

Results

The malpositioned locations of postplacement peripherally inserted central catheter tips mainly include right atrium, right ventricular, axillary vein, ipsilateral and contralateral internal jugular vein, subclavian vein, brachiocephalic vein, other small venous branches or catheter looped. Repositioning techniques contained automatic reposition, manual repositioning techniques, re-advancing catheters and catheters' replacement according to different malpositioned patterns.

Conclusions

The most appropriate repositioning techniques should be adopted on the basis of malpositioned locations, direction and length of the malpositioned tip, patients' integrated conditions and available medical equipments to maintain the catheter tip in the best position.

Relevance to clinical practice

The repositioning techniques described in this review can be applied in clinical practice to ensure the infusion therapy through peripherally inserted central catheter more economical and safe.

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