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 Journal Article


Authors: Climo, M.; Diekema, D.; Warren, D. K.; Herwaldt, L. A.; Perl, T. M.; Peterson, L.; Plaskett, T.; Price, C.; Sepkowitz, K.; Solomon, S.; Tokars, J.; Fraser, V. J.; Wong, E.
Article 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.
Keywords: controlled study; treatment outcome; major clinical study; mortality; internal jugular vein; nonhuman; united states; treatment indication; disease association; morbidity; prevalence; health survey; risk factor; hospital; health program; standardization; utilization review; intensive care unit; intensive care units; public health service; device; hospital patient; bacteremia; high risk population; hospital infection; catheter infection; infection control; health care surveys; cross infection; catheters, indwelling; urban population; central venous catheter; centers for disease control and prevention (u.s.); academic medical centers; catheterization, central venous; vascular access; teaching hospital; intravenous catheter; femoral vein; humans; human; article; peripheral vein; subclavian vein catheter; hospital units
Journal Title: Infection Control and Hospital Epidemiology
Volume: 24
Issue: 12
ISSN: 0899-823X
Publisher: The Society for Healthcare Epidemiology of America  
Date Published: 2003-12-01
Start Page: 942
End Page: 945
Language: English
DOI: 10.1086/502163
PUBMED: 14700410
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 12 September 2014 -- Source: Scopus
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MSK Authors
  1. Kent A Sepkowitz
    249 Sepkowitz