{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T02:47:28Z","timestamp":1767149248368,"version":"build-2238731810"},"reference-count":17,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T00:00:00Z","timestamp":1679616000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X22003063_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Peripherally inserted central catheters (PICCs) are increasingly used for vascular access in inpatient settings. Compared to multilumen PICCs, single-lumen PICCs carry a lower rate of complications, including central-line\u2013associated bloodstream infection and thrombosis. Despite this, multilumen PICCs are still overused.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X22003063_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This quality improvement initiative was implemented across 11 hospitals at New York City Health + Hospitals safety net system. The electronic health record (EHR) interventional radiology or vascular access team consultation orders were modified to allow for lumen choice, with default selection to a single-lumen PICC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X22003063_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Average single-lumen PICC utilization increased by 25.5%, from 44.4% to 69.9% (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). CLABSI rates had a nonsignificant reduction by 26.7% from 2.44 to 1.79 infections per month (\n                      <jats:italic>P<\/jats:italic>\n                      = .255). Among provider types in the postintervention period, single-lumen PICC utilization ranged from 67.7% for advanced practice providers to 82.4%\u201394.6% for physicians. Among provider specialties, utilization ranged from 31.8% for neurology to 97.7% for orthopedics. Additionally, there was large variation in pre- and postintervention differences in utilization by hospital.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X22003063_as4\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>We successfully increased single-lumen PICC utilization across all 11 safety net hospitals. This expands on previous work on improving single-lumen PICC use and use of default nudges in large, resource-limited settings. Further study is needed to examine variation among provider types, specialties, and hospitals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2022.306","type":"journal-article","created":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T06:15:18Z","timestamp":1679638518000},"page":"1381-1385","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":4,"title":["Nudging to select single-lumen over multiple-lumen peripherally inserted central catheters (PICCs) in a large safety net system"],"prefix":"10.1017","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5577-5159","authenticated-orcid":false,"given":"Daniel","family":"Alaiev","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mona","family":"Krouss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sigal","family":"Israilov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lara","family":"Musser","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3633-8279","authenticated-orcid":false,"given":"Joseph","family":"Talledo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nessreen","family":"Mestari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit","family":"Uppal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"Madaline","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8653-4518","authenticated-orcid":false,"given":"Gabriel","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathaniel","family":"Bravo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marialeah","family":"Cervantes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Contractor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter 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