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, Dan Diekema, David K. Warren, Loreen A. Herwaldt, Trish M. Perl, Lance Peterson, Theresa Plaskett, Connie Price, Kent Sepkowitz, Steve Solomon, Jerry Tokars, Victoria J. Fraser, Edward Wong

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)942-945
Number of pages4
JournalInfection Control and Hospital Epidemiology
Volume24
Issue number12
DOIs
StatePublished - Dec 2003

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Centers for Disease Control and Prevention (U.S.)
Intensive Care Units
Equipment and Supplies
Central Venous Catheters
Thigh
Inpatients
Neck
Catheters
Surveys and Questionnaires
Urban Hospitals
Infection Control
Teaching Hospitals
Morbidity
Mortality
Infection

ASJC Scopus subject areas

  • Microbiology (medical)
  • Immunology

Cite this

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. / Climo, Michael; Diekema, Dan; Warren, David K.; Herwaldt, Loreen A.; Perl, Trish M.; Peterson, Lance; Plaskett, Theresa; Price, Connie; Sepkowitz, Kent; Solomon, Steve; Tokars, Jerry; Fraser, Victoria J.; Wong, Edward.

In: Infection Control and Hospital Epidemiology, Vol. 24, No. 12, 12.2003, p. 942-945.

Research output: Contribution to journalArticle

Climo, Michael ; Diekema, Dan ; Warren, David K. ; Herwaldt, Loreen A. ; Perl, Trish M. ; Peterson, Lance ; Plaskett, Theresa ; Price, Connie ; Sepkowitz, Kent ; Solomon, Steve ; Tokars, Jerry ; Fraser, Victoria J. ; Wong, Edward. / 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. In: Infection Control and Hospital Epidemiology. 2003 ; Vol. 24, No. 12. pp. 942-945.
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title = "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",
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.",
author = "Michael Climo and Dan Diekema and Warren, {David K.} and Herwaldt, {Loreen A.} and Perl, {Trish M.} and Lance Peterson and Theresa Plaskett and Connie Price and Kent Sepkowitz and Steve Solomon and Jerry Tokars and Fraser, {Victoria J.} and Edward Wong",
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AU - Warren, David K.

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AU - Perl, Trish M.

AU - Peterson, Lance

AU - Plaskett, Theresa

AU - Price, Connie

AU - Sepkowitz, Kent

AU - Solomon, Steve

AU - Tokars, Jerry

AU - Fraser, Victoria J.

AU - Wong, Edward

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N2 - 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.

AB - 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.

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