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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

  • Michael Climo (a1), Dan Diekema (a2), David K. Warren (a3), Loreen A. Herwaldt (a2), Trish M. Perl (a4), Lance Peterson (a5), Theresa Plaskett (a6), Connie Price (a7), Kent Sepkowitz (a6), Steve Solomon (a8), Jerry Tokars (a8), Victoria J. Fraser (a3) and Edward Wong (a1)...
Abstract
AbstractObjective:

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.

Copyright
Corresponding author
Hunter Holmes McGuire Veteran Affairs Medical Center, 1201 Broad Rock Blvd., Section 111-C, Richmond, VA 23249
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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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