What impact does inappropriate catheter use have on the risk of adverse events and bloodstream infections? A recent paper in Journal of Hospital Infection aims to answer that question.
Using a prospective observational study design, the investigators developed definitions for appropriate intravascular device use, estimated the frequency of inappropriate use of intravascular devices, and examined risk factors and outcomes associated with inappropriate intravascular catheter use. Among 436 patients studied, the use of 876 intravascular devices (both peripgeral and central) was observed. Thirty one percent of all catheter days were found to be inappropriate.
Using logistic regression analysis, inappropriate usage was strongly associated with increased intensive care unit admission (OR 5.98 P < 0.05) and length of hospital stay (4.9 ± 4.3 days for appropriate vs 8.5 ± 12.6 days for inappropriate; P < 0.05).
Inappropriate device use was not significantly associated with collection of blood and catheter tip culture, presumably a surrogate marker for a bloodstream infection. Larger studies are needed to assess the impact, if any, of inappropriate intravascular device use and risk of bloodstream infection.
Perhaps our coveted central line checklists should have an initial 1st step: certify the need and appropriateness of intravascular catheterization prior to insertion.
Using logistic regression analysis, inappropriate usage was strongly associated with increased intensive care unit admission (OR 5.98 P < 0.05) and length of hospital stay (4.9 ± 4.3 days for appropriate vs 8.5 ± 12.6 days for inappropriate; P < 0.05).
Inappropriate device use was not significantly associated with collection of blood and catheter tip culture, presumably a surrogate marker for a bloodstream infection. Larger studies are needed to assess the impact, if any, of inappropriate intravascular device use and risk of bloodstream infection.
Perhaps our coveted central line checklists should have an initial 1st step: certify the need and appropriateness of intravascular catheterization prior to insertion.
