Unit of Infectious Diseases, Institute for Research Hospital "12 de Octubre" (i+12), University Hospital "12 de Octubre", Madrid, Spain; School of Medicine, Universidad Complutense, Madrid, Spain.
J Hosp Med. 2014 Jan;9(1):35-41. doi: 10.1002/jhm.2130. Epub 2013 Dec 9.
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.
The present study was aimed at analyzing the appropriateness of use of vascular catheters and catheter lumens in the inpatient setting.
Cross-sectional survey.
The entire population of adult inpatients admitted to a 1368-bed tertiary-care hospital in a single day.
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.
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.
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.
去除不必要的导管已被提议作为降低导管相关发病率的重要措施。然而，关于这种干预措施的潜在规模的信息却很少。
本研究旨在分析住院患者血管内导管和导管腔的使用是否恰当。
横断面调查。
在一天内，对一家拥有 1368 张床位的三级保健医院的所有成年住院患者进行调查。
我们使用一套预先确定的标准，根据静脉内药物的数量和管理方案，评估血管导管和导管腔的使用是否恰当。
在 834 名患者中，575 名（68.9%）在调查当天至少有 1 个血管内导管。在 703 个被调查的导管中，类型和分布为外周静脉导管，80.6%；中心静脉导管，15.8%；动脉导管，3.6%。我们发现每个导管的平均使用数量为 2.06±0.82 个，重症监护病房和普通病房之间存在显著差异（P<0.0001）。根据我们的标准，575 名患者中有 126 名（21.9%）的导管数量不当（内科病房，20.0%；外科病房，23.9%；重症监护病房，26.3%），14248 个非动脉导管腔中有 631 个（43.6%）被认为是不必要的。
作为降低导管相关血流感染发生率的潜在有用工具，血管内导管和导管腔的数量存在很大的改进空间。
