Pharmaceutical validation of peripherally inserted central catheters: four years of implementation

OBJECTIVES: Peripherally inserted central catheters (PICCs) are used in clinical settings for mid- to long-term intravenous therapies, including chemotherapy and antibiotics. However, their use involves risks such as infections, thrombosis or occlusions. Pharmacist-led analysis and validation of PICC requests aims to optimise their use and reduce complications. This study evaluates the sustainability of pharmacist-led PICC analysis and validation in a university hospital and investigates the organisation of PICC management in French healthcare institutions. METHODS: A single-centre retrospective observational study was conducted, analysing PICC requests from April 2018 to October 2021. Pharmaceutical interventions (PIs) were categorised based on their targets: applicants, installers or users. A national survey was also conducted to assess PICC practices across French hospitals. RESULTS: Of the 5503 requests over a 42-month period, 59.9% (3297) required at least one PI, totalling 4406 PIs. Most were directed at installers (69.2%), followed by applicants (18.4%) and users (12.4%). Pharmacists refused 4.1% (223) of requests, mainly due to alternative functional access or contraindications. Despite pharmacist validation, 14.0% (771) of PICC placements were later cancelled by the medical team (ie, transfer of the patient). The national survey revealed limited adoption of pharmaceutical validation, with only two centres (5%) implementing it out of 37 respondents, even though 40 centres (98%) had over 2 years of experience with PICCs. CONCLUSIONS: Pharmacist-led PICCs validation improves patient safety and optimises device use, demonstrating its value and sustainability in clinical practice. The percentage of refusals has remained stable since our pilot study in 2018 in the same centre, probably due to fast staff turnover. Wider implementation of this practice requires addressing resource limitations, raising awareness about the pharmacist's role in managing medical devices, and frequent training.