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Temporary Central Venous Catheter Utilization Patterns in a Large Tertiary Care Center Tracking the “Idle Central Venous Catheter”

Published online by Cambridge University Press:  02 January 2015

Sheri Chernetsky Tejedor ,
David Tong ,
Jason Stein ,
Christina Payne ,
Daniel Dressler ,
Wenqiong Xue  and
James P. Steinberg
Sheri Chernetsky Tejedor*
Affiliation:
Division of Hospital Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia Information Services, Emory Healthcare, Atlanta, Georgia
David Tong
Affiliation:
Division of Hospital Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
Jason Stein
Affiliation:
Division of Hospital Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia Information Services, Emory Healthcare, Atlanta, Georgia
Christina Payne
Affiliation:
Division of Hospital Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
Daniel Dressler
Affiliation:
Division of Hospital Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
Wenqiong Xue
Affiliation:
Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
James P. Steinberg
Affiliation:
Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
*
Division of Hospital Medicine, Emory University School of Medicine, 1364 Clifton Road NE, Box M-7, Atlanta, GA 30322 ([email protected])
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Abstract

Objectives.

Although central venous catheter (CVC) dwell time is a major risk factor for catheter-related bloodstream infections (CR-BSIs), few studies reveal how often CVCs are retained when not needed (“idle”). We describe use patterns for temporary CVCs, including peripherally inserted central catheters (PICCs), on non-ICU wards.

Design.

A retrospective observational study.

Setting.

A 579-bed acute care, academic tertiary care facility.

Methods.

A retrospective observational study of a random sample of patients on hospital wards who have a temporary, nonimplanted CVC, with a focus on on daily ward CVC justification. A uniform definition of idle CVC-days was used.

Results.

We analyzed 89 patients with 146 CVCs (56% of which were PICCs); of 1,433 ward CVC-days, 361 (25.2%) were idle. At least 1 idle day was observed for 63% of patients. Patients had a mean of 4.1 idle days and a mean of 3.4 days with both a CVC and a peripheral intravenous catheter (PIV). After adjusting for ward length of stay, mean CVC dwell time was 14.4 days for patients with PICCs versus 9.0 days for patients with non-PICC temporary CVCs (other CVCs; P< .001). Patients with a PICC had 5.4 days in which they also had a PIV, compared with 10 days in other CVC patients (P< .001). Patients with PICCs had more days in which the only justification for the CVC was intravenous administration of antimicrobial agents (8.5 vs 1.6 days; P = .0013).

Conclusions.

Significant proportions of ward CVC-days were unjustified. Reducing “idle CVC-days” and facilitating the appropriate use of PIVs may reduce CVC-days and CR-BSI risk.

Infect Control Hosp Epidemiol 2012;33(1):50-57

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 33 , Issue 1 , January 2012 , pp. 50 - 57
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

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