A Study Comparing Coagulation Test Results from PICCs and Venipunctures

Abstract

Problem

Hospitalized patients, particularly those with PICC lines, may require anticoagulation therapy or coagulation studies to determine changes in condition. Venipuncture, a painful procedure, often results in bruising, bleeding and increased risk for infection. It is particularly difficult in some patients with limited venous access. Our policy/procedure requires venipuncture to obtain all coagulation test samples.

Evidence

A review of published literature supported the use of PICC lines for coagulation studies when proper protocol is followed.

Strategy

An evidence-based protocol was developed for drawing coagulation studies from PICC lines. The study compared results from coagulation studies drawn from a PICC using the evidence-based protocol, and samples drawn via venipuncture.

Practice Change

The clinical research study was designed to determine if the policy/procedure requiring venipuncture for coagulation studies could be revised. The goal was to show no significant difference between coagulation study results drawn via venipuncture and via PICC lines using an evidence-based protocol. The results will be used to validate a change in policy/procedure.

Evaluation

The study compared PT, PTT, INR, and Fibrinogen results from blood samples obtained via venipuncture and via a PICC line using an evidence-based protocol.

Results

Purposive sampling was used. All patients admitted to the hospital with PICC lines were asked to participate in the study. Thirty patients consented to have blood collected from a peripheral vein via venipuncture and through the PICC line following protocol. PTT, PT, INR and Fibrinogen tests were run on all samples. Results were compared using Pearson product moment correlations and paired t-tests. There were no statistically significant differences in any of the coagulation tests drawn on patients peripherally using venipuncture or samples drawn through the PICC line.

Recommendations

The current policy can be revised to allow coagulation studies to be drawn from PICC lines using an evidence-based protocol.

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