Date of Award

Spring 2021

Document Type

DNP Project

Degree Name

Doctor of Nursing Practice (DNP)



Committee Chairperson

Jacquelyn Owens, DNP, CRNP

Committee Member

Kelly Ann Zazyczny, MSN, RN

Committee Member

Veronica Wilbur, PhD, FNP, CNE, FAANP


Catheter-related thrombosis (CRT) is a potential complication of peripherally inserted central catheters (PICCs). With PICC use becoming more common, it is important to minimize this complication. Selection of an appropriately sized vessel can reduce the risk of catheter-related thrombosis. Research suggests that using a catheter-to-vessel-ratio (CVR) of 45% or less can minimize this risk. This quality improvement project was implemented to evaluate the impact of utilizing an ultrasound device that can measure catheter-to vessel ratio with peripherally inserted central catheter insertion by the vascular access team.

Data was collected using a retrospective chart review looking at CRT rates before and after implementation of an ultrasound device that measures CVR to identify and use vessels with a CVR of 45% or less to insert PICCs. While there was no statistically significant difference, data suggests that using a CVR of 45% or less decreases the incidence of CRT. Results also reinforce previous research that cancer diagnosis as well as insertion of larger gauge PICCs were associated with deep vein thrombosis. Future studies that include larger sample sizes to validate this measurement are recommended.

Keywords: Catheter-to-Vessel-Ratio (CVR), Peripherally Inserted Central Catheter (PICC), Catheter-Related-Thrombosis (CRT), Deep Vein Thrombosis (DVT)