The development of a risk score for unplanned removal of peripherally inserted central catheter in newborns.


OBJECTIVE: to develop a risk score for unplanned removal of peripherally inserted central catheter in newborns. METHOD: prospective cohort study conducted in a neonatal intensive care unit with newborn babies who underwent 524 catheter insertions. The clinical characteristics of the newborn, catheter insertion and intravenous therapy were tested as risk factors for the unplanned removal of catheters using bivariate analysis. The risk score was developed using logistic regression. Accuracy was internally validated based on the area under the Receiver Operating Characteristic curve. RESULTS: the risk score was made up of the following risk factors: transient metabolic disorders; previous insertion of catheter; use of a polyurethane double-lumen catheter; infusion of multiple intravenous solutions through a single-lumen catheter; and tip in a noncentral position. Newborns were classified into three categories of risk of unplanned removal: low (0 to 3 points), moderate (4 to 8 points), and high (≥ 9 points). Accuracy was 0.76. CONCLUSION: the adoption of evidence-based preventative strategies based on the classification and risk factors faced by the newborn is recommended to minimize the occurrence of unplanned removals.





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Publication Info

Costa, Priscila, Amélia Fumiko Kimura, Debra Huffman Brandon, Eny Dorea Paiva and Patricia Ponce de Camargo (2015). The development of a risk score for unplanned removal of peripherally inserted central catheter in newborns. Rev Lat Am Enfermagem, 23(3). pp. 475–482. 10.1590/0104-1169.0491.2578 Retrieved from

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Debra Huffman Brandon

Professor in the School of Nursing

Debra Brandon, Associate Professor joined the faculty of the Duke University School of Nursing in 1999. She was Director of the PhD Program in Nursing from from July of 2011 until January 30th of 2018.  She also practiced as a Neonatal Clinical Nurse Specialist in the Intensive Care Nursery of Duke University Medical Center from 1993 to 2012. Dr. Brandon is an active member of the National Association of Neonatal Nurses (NANN), the International Society for Infant Studies ISIS), and is a Co-editor in Chief for the journal Advances in Neonatal Care.  Dr. Brandon’s research focuses on understanding the impact of the environment of care on the health and development of high-risk infants and young children with an overall goal of implementing interventions to improve the short- and long-term outcomes of both the infants and their families.

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