Unnecessary Use of Central Venous Catheters: The Need to Look Outside the Intensive Care Unit

Trick, William E.; Vernon, Michael O.; Welbel, Sharon F.; Wisniewski, Mary F.; Jernigan, John A.; Weinstein, Robert A.

doi:10.1086/502390

Cited by 66 publications

(69 citation statements)

References 7 publications

(1 reference statement)

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“…[4][5][6] However, the majority of nontunneled central venous catheters in use in hospitals at any one time are present in non-ICU patients 7 and tend to remain in these patients for longer durations, without a clear clinical indication for their use. 8 Interestingly, the epidemiology of CA-BSI has rarely been investigated outside the ICU setting. A recent study highlighted the influence of central venous catheters and urinary catheters on infections in non-ICU patients and demonstrated several differences between non-ICU and ICU patients.…”

mentioning

confidence: 99%

Catheter-Associated Bloodstream Infections in General Medical Patients Outside the Intensive Care Unit: A Surveillance Study

Marschall

Leone

Jones

et al. 2007

Infect. Control Hosp. Epidemiol.

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mentioning

confidence: 99%

Catheter-Associated Bloodstream Infections in General Medical Patients Outside the Intensive Care Unit: A Surveillance Study

Marschall

Leone

Jones

et al. 2007

Infect. Control Hosp. Epidemiol.

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“…[5][6][7]9 Data collection and surveillance of BSIs has been recommended, but primarily for intensive care units (ICUs), 10,11 even though most CVCs are used outside ICUs. 12 To prevent the occurrence of BSIs and improve management practices, we implemented a hospital-wide surveillance and intervention program.…”

Section: R Esearchmentioning

confidence: 99%

Intravascular catheter bloodstream infections: an effective and sustained hospital-wide prevention program over 18 years

Kimber

Collignon

Broadrick

et al. 2017

Infection, Disease & Health

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“…10,11 Furthermore, the utility of currently promoted interventions to ensure prompt removal of nonessential CVCs (e.g., the use of checklists as a reminder) is not well known. In a previous observational study in the ICUs of Kingston General Hospital, Ontario, Canada, we discovered that 51% of the patients had at least one CVC day with no apparent indication for CVC placement.…”

Section: Résumémentioning

confidence: 99%

Removing nonessential central venous catheters: evaluation of a quality improvement intervention

Ilan

Doan

Cload

et al. 2012

Can J Anesth/J Can Anesth

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Introduction Nonessential central venous catheters (CVCs) should be removed promptly to prevent adverse events. Little is known about effective strategies to achieve this goal. The present study evaluates the effectiveness of a quality improvement (QI) initiative to remove nonessential CVCs in the intensive care unit (ICU).Methods A prospective observational study was performed in two ICUs following a QI intervention that included a daily checklist, education, and reminders. During 28 consecutive days, all CVCs were identified and the presence of ongoing indications for CVC placement was recorded. The proportions of nonessential CVCs and CVC days were compared with pre-intervention proportions and between the participating units. Rates of central line-associated bloodstream infections (CLABSI) were measured separately through Ontario's Critical Care Information System. Results One hundred and ten patients and 159 CVCs were reviewed. Eighty-eight (11%) of 820 catheter days showed no apparent indication for CVC placement, and compared with the pre-intervention period, the proportion of patients with any number of nonessential CVC days decreased from 51% to 26% (relative risk 0.51; 95% confidence interval 0.34 to 0.74; P \ 0.001). There was no significant difference in the proportion of nonessential catheter days between participating units. Reported rates of CLABSI decreased substantially during the intervention. Discussion A checklist tool supported by a multifaceted QI intervention effectively ensured prompt removal of nonessential CVCs in two ICUs. RésuméIntroduction Les cathe´ters veineux centraux (CVC) non essentiels doivent eˆtre retire´s rapidement afin de pre´venir les effets inde´sirables. On ne sait que peu de choses sur les strate´gies efficaces permettant d'atteindre cet objectif. La pre´sente e´tude e´value l'efficacite´d'une initiative d'ame´lioration de la qualite´pour supprimer les CVC non essentiels dans une unite´de soins intensifs (USI). Méthode Une e´tude observationnelle prospective a e´te´mene´e dans deux USI suite a`une intervention

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Unnecessary Use of Central Venous Catheters: The Need to Look Outside the Intensive Care Unit

Cited by 66 publications

References 7 publications

Catheter-Associated Bloodstream Infections in General Medical Patients Outside the Intensive Care Unit: A Surveillance Study

Catheter-Associated Bloodstream Infections in General Medical Patients Outside the Intensive Care Unit: A Surveillance Study

Intravascular catheter bloodstream infections: an effective and sustained hospital-wide prevention program over 18 years

Removing nonessential central venous catheters: evaluation of a quality improvement intervention

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