Hospital-wide survey of the use of central venous catheters

Zingg, Walter; Sandoz, L.; İnan, Ciḡdem; Cartier, Vanessa; Clergue, F.; Pittet, Didier; Walder, Bernhard

doi:10.1016/j.jhin.2010.11.011

Cited by 38 publications

(36 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…CVC use in non-ICU locations requires the same intensity of focus as it has received in the ICU. [55][56][57][58][59][60] A national clinician-directed system for sustained continuous CVC-BSI benchmarking, such as those in Scotland 61 and Wales, 62 would ensure continued attention to CVC-BSIs, and could provide a platform for monitoring other healthcare-associated infections with linkage to patient outcomes.…”

Section: Discussionmentioning

confidence: 99%

‘Matching Michigan’: a 2-year stepped interventional programme to minimise central venous catheter-blood stream infections in intensive care units in England

et al. 2012

View full text Add to dashboard Cite

BackgroundBloodstream infections from central venous catheters (CVC-BSIs) increase morbidity and costs in intensive care units (ICUs). Substantial reductions in CVC-BSI rates have been reported using a combination of technical and non-technical interventions.MethodsWe conducted a 2-year, four-cluster, stepped non-randomised study of technical and non-technical (behavioural) interventions to prevent CVC-BSIs in adult and paediatric ICUs in England. Random-effects Poisson regression modelling was used to compare infection rates. A sample of ICUs participated in data verification.ResultsOf 223 ICUs in England, 215 (196 adult, 19 paediatric) submitted data on 2479 of 2787 possible months and 147 (66%) provided complete data. The exposure rate was 438 887 (404 252 adult and 34 635 paediatric) CVC-patient days. Over 20 months, 1092 CVC-BSIs were reported. Of these, 884 (81%) were ICU acquired. For adult ICUs, the mean CVC-BSI rate decreased over 20 months from 3.7 in the first cluster to 1.48 CVC-BSIs/1000 CVC-patient days (p<0.0001) for all clusters combined, and for paediatric ICUs from 5.65 to 2.89 (p=0.625). The trend for infection rate reduction did not accelerate following interventions training. CVC utilisation rates remained stable. Pre-ICU infections declined in parallel with ICU-acquired infections. Criterion-referenced case note review showed high agreement between adjudicators (κ 0.706) but wide variation in blood culture sampling rates and CVC utilisation. Generic infection control practices varied widely.ConclusionsThe marked reduction in CVC-BSI rates in English ICUs found in this study is likely part of a wider secular trend for a system-wide improvement in healthcare-associated infections. Opportunities exist for greater harmonisation of infection control practices. Future studies should investigate causal mechanisms and contextual factors influencing the impact of interventions directed at improving patient care.

show abstract

Section: Discussionmentioning

confidence: 99%

‘Matching Michigan’: a 2-year stepped interventional programme to minimise central venous catheter-blood stream infections in intensive care units in England

et al. 2012

View full text Add to dashboard Cite

show abstract

“…An initial and crucial step in preventing CRBSIs is to weight and consider the risks and benefits of using a CVC in order to avoid unnecessary placements; indeed, in a recent hospital survey it was calculated that among a total of 378 CVCs inserted in 292 patients, accounting for 2704 catheter-days, 130 catheter-days (4.8%) were unnecessary, with a higher proportion in non-ICU settings (6.6%) [69]. Various risk factors involving insertion or catheter handling have been described in the literature.…”

Section: Prevention Of Catheter-related Bloodstream Infectionsmentioning

confidence: 99%

Central venous catheter-related biofilm infections: An up-to-date focus on meticillin-resistant Staphylococcus aureus

Esposito

Purrello

Bonnet

et al. 2013

Journal of Global Antimicrobial Resistance

View full text Add to dashboard Cite

“…1–4 Central venous catheters (CVCs) are used for many reasons including facilitating administration of certain medications, augmenting hemodynamic monitoring including determination of central venous oxygenation, and providing venous access when peripheral access is limited. 5–8 …”

Section: Introductionmentioning

confidence: 99%

Variation of Arterial and Central Venous Catheter Use in United States Intensive Care Units

et al. 2014

View full text Add to dashboard Cite

Background Arterial (AC) and central venous catheterization (CVC) are common in intensive care units (ICUs). Few data describe which patients receive these devices and whether variability in practice exists. Methods We conducted an observational cohort study of adult ICU admissions during 2001–2008 using Project IMPACT to determine whether AC and CVC use is consistent across United States ICUs. We examined trends over time and patients more (mechanically ventilated or on vasopressors) or less (predicted risk of hospital mortality ≤2%) likely to receive either catheter. Results Our cohort included 334,123 patients across 122 hospitals and 168 ICUs. Unadjusted AC usage rates remained constant (36.9% (2001) versus 36.4% (2008); P = 0.212) while CVC use increased (from 33.4% (2001) to 43.8% (2008), P < 0.001 comparing 2001 and 2008); adjusted AC usage rates were constant from 2004 (35.2%) to 2008 (36.4%, P = 0.43 for trend). Surgical ICUs used both catheters most often (unadjusted rates, ACs: 56.0% of patients vs. 22.4% in medical and 32.6% in combined units, P < 0.001; CVCs: 46.9% vs. 32.5% and 36.4%, P < 0.001). There was wide variability in AC use across ICUs in patients receiving mechanical ventilation (median (interquartile range): 49.2% (29.9%, 72.3%); adjusted Median Odds-Ratio (AMOR) 2.56), vasopressors (51.7% (30.8%,76.2%); AMOR 2.64), and with predicted mortality ≤2% (31.7% (19.5, 49.3%); AMOR 1.94). There was less variability in CVC use (mechanical ventilation: 63.4% (54.9%, 72.9%), AMOR 1.69; vasopressors: 71.4% (59.5%, 85.7%), AMOR 1.93; predicted mortality ≤2%: 18.7% (11.9%, 27.3%), AMOR 1.90). Conclusions Both ACs and CVCs are common in ICU patients. There is more variation in use of ACs than CVCs.

show abstract

Hospital-wide survey of the use of central venous catheters

Cited by 38 publications

References 26 publications

‘Matching Michigan’: a 2-year stepped interventional programme to minimise central venous catheter-blood stream infections in intensive care units in England

‘Matching Michigan’: a 2-year stepped interventional programme to minimise central venous catheter-blood stream infections in intensive care units in England

Central venous catheter-related biofilm infections: An up-to-date focus on meticillin-resistant Staphylococcus aureus

Variation of Arterial and Central Venous Catheter Use in United States Intensive Care Units

Contact Info

Product

Resources

About