Clinicians at all levels of training and specialties frequently did not know which of their patients currently had central venous catheters, or CVCs, according to an article being published in Annals of Internal Medicine.
CVCs are inserted in both intensive care unit patients and non-intensive care unit patients to provide reliable venous access for tasks such as laboratory monitoring and delivering medications. The two most commonly used CVCs are nontunneled triple-lumen catheters placed in the neck or femoral veins and peripherally inserted central catheters (PICCs) inserted in the arm. CVCs that are no longer needed should be promptly removed to avoid potential complications, such as bloodstream infections and blood clots, but evidence suggests that CVCs often remain in place longer than they are necessary.
Researchers sought to determine how often clinicians were aware of the presence of triple-lumen or PICCs in hospitalized patients. They evaluated 990 patients to ascertain the presence of CVCs and then surveyed clinicians to determine their knowledge of the patients' CVC status. They found that clinicians at all levels of training and specialties frequently did not know which patients had CVCs. Hospitalists and teaching attendings were less likely to be aware of CVCs in place. The authors suggest that these findings have significant patient safety and policy implications and recommend policies and procedures to oversee the visibility of CVCs, especially in non-intensive care unit settings.
Study: Do Clinicians Know Which of Their Patients Have Central Venous Catheters?: A Multicenter Observational Study, Vineet Chopra, MD, MSc; Sushant Govindan, MD; Latoya Kuhn, MPH; David Ratz, MS; Randy F. Sweis, MD; Natalie Melin, BA; Rachel Thompson, MD; Aaron Tolan, MD; James Barron, MD; and Sanjay Saint, MD, MPH, Annals of Internal Medicine, doi:10.7326/M14-0703, published 21 October 2014.