Femorally inserted central catheters with exit site at mid-thigh in an American veteran population: A program evaluation on the implementation at a VA Medical Center.

BACKGROUND: Veterans experience disproportionately high rates of chronic illness and hospital utilization, making reliable vascular access for intravenous therapy a persistent clinical challenge. This 2-year quality improvement project evaluated the implementation of mid-thigh femorally inserted central catheters (MT-FICCs) at a Veterans Affairs Medical Center in the South as an innovative strategy to improve vascular access reliability and support therapy completion. METHODS: The evaluation focused on three primary outcomes: insertion success rate, device dwell time, and catheter related complications, including infection, malposition, thrombosis, and mechanical failure due to kinking. Data from 138 Veterans who underwent 172 superficial femoral or greater saphenous vein central venous catheter insertions across separate episodes of care were collected through post-procedure documentation and weekly chart reviews. Descriptive statistics were used for analysis. RESULTS: MT-FICCs demonstrated a 99.4% (n = 171) insertion success rate and reliable dwell times (mean = 17.31 days; median = 9 days), supporting uninterrupted intravenous therapy across care transitions. No catheter related bloodstream infections occurred. Mechanical failure due to kinking (n = 18, 10.5%) was minimized through catheter design modifications and tunneling techniques. Of nine mispositioned catheters, seven were corrected without replacement via power flushing. CONCLUSION: MT-FICCs are a safe, feasible, and reliable bedside vascular access option for Veterans requiring long-term intravenous therapy. Findings from this evaluation support broader adoption of MT-FICCs across Veterans Health Administration facilities to enhance vascular access reliability and preserve upper-extremity vasculature. ETHICAL CONSIDERATIONS: This quality improvement project has been formally evaluated using a quality improvement checklist by the Dallas VA Medical Center and Duke University School of Nursing and determined not to be human subjects' research. Therefore, informed consent is not applicable for this project. All data were handled in compliance with federal privacy regulations and institutional policies, ensuring confidentiality, secure storage, and minimal risk to patients.