Hospital-wide survey of the adequacy in the number of vascular catheters and catheter lumens.

BACKGROUND

Removal of unnecessary catheters has been proposed as an important measure to reduce catheter-related morbidity. Nevertheless, there is scarce information about the potential magnitude of such intervention.

OBJECTIVE

The present study was aimed at analyzing the appropriateness of use of vascular catheters and catheter lumens in the inpatient setting.

DESIGN

Cross-sectional survey.

SETTING

The entire population of adult inpatients admitted to a 1368-bed tertiary-care hospital in a single day.

MEASUREMENTS

We used a set of preestablished criteria to evaluate the appropriateness of use of vascular catheters and catheter lumens according to the number and administration regimen of intravenous drugs.

RESULTS

Out of 834 patients, 575 (68.9%) had ≥1 vascular catheters in place on the day of the survey. The type and distribution of the 703 surveyed catheters were peripheral venous catheter, 80.6%; central venous catheter, 15.8%; and arterial catheter, 3.6%. We found an overall mean of 2.06 ± 0.82 lumens per catheter, with significant differences between intensive care units and conventional wards (P < 0.0001). Based on our criteria, 126 out of 575 patients (21.9%) had an inappropriate number of catheters (medical wards, 20.0%; surgical wards, 23.9%; intensive care units, 26.3%), and 631 out of 14248 nonarterial catheter lumens (43.6%) were considered unnecessary.

CONCLUSIONS

Significant room exists for improving the adequacy of the number of vascular catheters and catheter lumens as a potentially useful tool for decreasing the incidence of catheter-related bloodstream infection.