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Prevalence of the Use of Central Venous Access Devices Within and Outside of the Intensive Care Unit: Results of a Survey Among Hospitals in the Prevention Epicenter Program of the Centers for Disease Control and Prevention

Published online by Cambridge University Press:  02 January 2015

Michael Climo ,
Dan Diekema ,
David K. Warren ,
Loreen A. Herwaldt ,
Trish M. Perl ,
Lance Peterson ,
Theresa Plaskett ,
Connie Price ,
Kent Sepkowitz  and
Steve Solomon
...Show all authors
Michael Climo*
Affiliation:
Hunter Holmes McGuire Veteran Affairs Medical Center, Richmond, Virginia
Dan Diekema
Affiliation:
University of Iowa College of Medicine, Iowa City, Iowa
David K. Warren
Affiliation:
Washington University School of Medicine, St. Louis, Missouri
Loreen A. Herwaldt
Affiliation:
University of Iowa College of Medicine, Iowa City, Iowa
Trish M. Perl
Affiliation:
Johns Hopkins Medical Institutions, Baltimore, Maryland
Lance Peterson
Affiliation:
Evanston Northwestern Healthcare Research Institute, Evanston, Illinois
Theresa Plaskett
Affiliation:
Memorial Sloan Kettering Hospital, New York, New York
Connie Price
Affiliation:
University of Colorado Health Sciences Center, Denver, Colorado
Kent Sepkowitz
Affiliation:
Memorial Sloan Kettering Hospital, New York, New York
Steve Solomon
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Jerry Tokars
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Victoria J. Fraser
Affiliation:
Washington University School of Medicine, St. Louis, Missouri
Edward Wong
Affiliation:
Hunter Holmes McGuire Veteran Affairs Medical Center, Richmond, Virginia
*
Hunter Holmes McGuire Veteran Affairs Medical Center, 1201 Broad Rock Blvd., Section 111-C, Richmond, VA 23249
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Abstract

Objective:

To determine the prevalence of central venous catheter (CVC) use among patients both within and outside the ICU setting.

Design:

A 1-day prevalence survey of CVC use among adult inpatients at six medical centers participating in the Prevention Epicenter Program of the CDC. Using a standardized form, observers at each Epicenter performed a hospital-wide survey, collecting data on CVC use.

Setting:

Inpatient wards and ICUs of six large urban teaching hospitals.

Results:

At the six medical centers, 2,459 patients were surveyed; 29% had CVCs. Among the hospitals, from 43% to 80% (mean, 59.3%) of ICU patients and from 7% to 39% (mean, 23.7%) of non-ICU patients had CVCs. Despite the lower rate of CVC use on non-ICU wards, the actual number of CVCs outside the ICUs exceeded that of the ICUs. Most catheters were inserted in the subclavian (55%) or jugular (22%) site, with femoral (6%) and peripheral (15%) sites less commonly used. The jugular (33.0% vs 16.6%; P < .001) and femoral (13.8% vs 2.7%; P < .001) sites were more frequently used in ICU patients, whereas peripherally inserted (19.9% vs 5.9%; P < .001) and subclavian (60.7% vs 47.3%; P < .001) catheters were more commonly used in non-ICU patients.

Conclusions:

Current surveillance and infection control efforts to reduce morbidity and mortality associated with bloodstream infections concentrate on the high-risk ICU patients with CVCs. Our survey demonstrated that two-thirds of identified CVCs were not in ICU patients and suggests that more efforts should be directed to patients with CVCs who are outside the ICU.

Information

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 12 , December 2003 , pp. 942 - 945
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003 

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