Do clinicians know which of their patients have central venous catheters? A multicenter observational study

Vineet Chopra, Sushant Govindan, Latoya Kuhn, David Ratz, Randy F. Sweis, Natalie Melin, Rachel E Thompson, Aaron Tolan, James Barron, Sanjay Saint

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Complications associated with central venous catheters (CVCs) increase over time. Although early removal of unnecessary CVCs is important to prevent complications, the extent to which clinicians are aware that their patients have a CVC is unknown.

Objective: To assess how often clinicians were unaware of the presence of triple-lumen catheters or peripherally inserted central catheters (PICCs) in hospitalized patients.

Design: Multicenter, cross-sectional study.

Setting: 3 academic medical centers in the United States. Patients: Hospitalized medical patients in intensive care unit (ICU) and non-ICU settings.

Measurements: To ascertain awareness of CVCs, whether a PICC or triple-lumen catheter was present was determined; clinicians were then queried about device presence. Differences in device awareness among clinicians were assessed by chi-square tests.

Results: 990 patients were evaluated, and 1881 clinician assessments were done. The overall prevalence of CVCs was 21.1% (n = 209), of which 60.3% (126 of 209) were PICCs. A total of 21.2% (90 of 425) of clinicians interviewed were unaware of the presence of a CVC. Unawareness was greatest among patients with PICCs, where 25.1% (60 of 239) of clinicians were unaware of PICC presence. Teaching attendings and hospitalists were more frequently unaware of the presence of CVCs than interns and residents (25.8% and 30.5%, respectively, vs. 16.4%). Critical care physicians were more likely to be aware of CVC presence than general medicine physicians (12.6% vs. 26.2%; P = 0.003). Limitations: Awareness was determined at 1 point in time and was not linked to outcomes. Patient length of stay and indication for CVC were not recorded.

Conclusion: Clinicians are frequently unaware of the presence of PICCs and triple-lumen catheters in hospitalized patients. Further study of mechanisms that ensure that clinicians are aware of these devices so that they may assess their necessity seems warranted.

Original languageEnglish (US)
Pages (from-to)562-567
Number of pages6
JournalAnnals of internal medicine
Volume161
Issue number8
DOIs
StatePublished - Oct 21 2014

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Central Venous Catheters
Multicenter Studies
Observational Studies
Catheters
Equipment and Supplies
Hospitalists
Physicians
Chi-Square Distribution
Critical Care
Intensive Care Units
Length of Stay
Teaching
Cross-Sectional Studies
Medicine

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Chopra, V., Govindan, S., Kuhn, L., Ratz, D., Sweis, R. F., Melin, N., ... Saint, S. (2014). Do clinicians know which of their patients have central venous catheters? A multicenter observational study. Annals of internal medicine, 161(8), 562-567. https://doi.org/10.7326/M14-0703

Do clinicians know which of their patients have central venous catheters? A multicenter observational study. / Chopra, Vineet; Govindan, Sushant; Kuhn, Latoya; Ratz, David; Sweis, Randy F.; Melin, Natalie; Thompson, Rachel E; Tolan, Aaron; Barron, James; Saint, Sanjay.

In: Annals of internal medicine, Vol. 161, No. 8, 21.10.2014, p. 562-567.

Research output: Contribution to journalArticle

Chopra, V, Govindan, S, Kuhn, L, Ratz, D, Sweis, RF, Melin, N, Thompson, RE, Tolan, A, Barron, J & Saint, S 2014, 'Do clinicians know which of their patients have central venous catheters? A multicenter observational study', Annals of internal medicine, vol. 161, no. 8, pp. 562-567. https://doi.org/10.7326/M14-0703
Chopra, Vineet ; Govindan, Sushant ; Kuhn, Latoya ; Ratz, David ; Sweis, Randy F. ; Melin, Natalie ; Thompson, Rachel E ; Tolan, Aaron ; Barron, James ; Saint, Sanjay. / Do clinicians know which of their patients have central venous catheters? A multicenter observational study. In: Annals of internal medicine. 2014 ; Vol. 161, No. 8. pp. 562-567.
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abstract = "Background: Complications associated with central venous catheters (CVCs) increase over time. Although early removal of unnecessary CVCs is important to prevent complications, the extent to which clinicians are aware that their patients have a CVC is unknown.Objective: To assess how often clinicians were unaware of the presence of triple-lumen catheters or peripherally inserted central catheters (PICCs) in hospitalized patients.Design: Multicenter, cross-sectional study.Setting: 3 academic medical centers in the United States. Patients: Hospitalized medical patients in intensive care unit (ICU) and non-ICU settings.Measurements: To ascertain awareness of CVCs, whether a PICC or triple-lumen catheter was present was determined; clinicians were then queried about device presence. Differences in device awareness among clinicians were assessed by chi-square tests.Results: 990 patients were evaluated, and 1881 clinician assessments were done. The overall prevalence of CVCs was 21.1{\%} (n = 209), of which 60.3{\%} (126 of 209) were PICCs. A total of 21.2{\%} (90 of 425) of clinicians interviewed were unaware of the presence of a CVC. Unawareness was greatest among patients with PICCs, where 25.1{\%} (60 of 239) of clinicians were unaware of PICC presence. Teaching attendings and hospitalists were more frequently unaware of the presence of CVCs than interns and residents (25.8{\%} and 30.5{\%}, respectively, vs. 16.4{\%}). Critical care physicians were more likely to be aware of CVC presence than general medicine physicians (12.6{\%} vs. 26.2{\%}; P = 0.003). Limitations: Awareness was determined at 1 point in time and was not linked to outcomes. Patient length of stay and indication for CVC were not recorded.Conclusion: Clinicians are frequently unaware of the presence of PICCs and triple-lumen catheters in hospitalized patients. Further study of mechanisms that ensure that clinicians are aware of these devices so that they may assess their necessity seems warranted.",
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AU - Chopra, Vineet

AU - Govindan, Sushant

AU - Kuhn, Latoya

AU - Ratz, David

AU - Sweis, Randy F.

AU - Melin, Natalie

AU - Thompson, Rachel E

AU - Tolan, Aaron

AU - Barron, James

AU - Saint, Sanjay

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N2 - Background: Complications associated with central venous catheters (CVCs) increase over time. Although early removal of unnecessary CVCs is important to prevent complications, the extent to which clinicians are aware that their patients have a CVC is unknown.Objective: To assess how often clinicians were unaware of the presence of triple-lumen catheters or peripherally inserted central catheters (PICCs) in hospitalized patients.Design: Multicenter, cross-sectional study.Setting: 3 academic medical centers in the United States. Patients: Hospitalized medical patients in intensive care unit (ICU) and non-ICU settings.Measurements: To ascertain awareness of CVCs, whether a PICC or triple-lumen catheter was present was determined; clinicians were then queried about device presence. Differences in device awareness among clinicians were assessed by chi-square tests.Results: 990 patients were evaluated, and 1881 clinician assessments were done. The overall prevalence of CVCs was 21.1% (n = 209), of which 60.3% (126 of 209) were PICCs. A total of 21.2% (90 of 425) of clinicians interviewed were unaware of the presence of a CVC. Unawareness was greatest among patients with PICCs, where 25.1% (60 of 239) of clinicians were unaware of PICC presence. Teaching attendings and hospitalists were more frequently unaware of the presence of CVCs than interns and residents (25.8% and 30.5%, respectively, vs. 16.4%). Critical care physicians were more likely to be aware of CVC presence than general medicine physicians (12.6% vs. 26.2%; P = 0.003). Limitations: Awareness was determined at 1 point in time and was not linked to outcomes. Patient length of stay and indication for CVC were not recorded.Conclusion: Clinicians are frequently unaware of the presence of PICCs and triple-lumen catheters in hospitalized patients. Further study of mechanisms that ensure that clinicians are aware of these devices so that they may assess their necessity seems warranted.

AB - Background: Complications associated with central venous catheters (CVCs) increase over time. Although early removal of unnecessary CVCs is important to prevent complications, the extent to which clinicians are aware that their patients have a CVC is unknown.Objective: To assess how often clinicians were unaware of the presence of triple-lumen catheters or peripherally inserted central catheters (PICCs) in hospitalized patients.Design: Multicenter, cross-sectional study.Setting: 3 academic medical centers in the United States. Patients: Hospitalized medical patients in intensive care unit (ICU) and non-ICU settings.Measurements: To ascertain awareness of CVCs, whether a PICC or triple-lumen catheter was present was determined; clinicians were then queried about device presence. Differences in device awareness among clinicians were assessed by chi-square tests.Results: 990 patients were evaluated, and 1881 clinician assessments were done. The overall prevalence of CVCs was 21.1% (n = 209), of which 60.3% (126 of 209) were PICCs. A total of 21.2% (90 of 425) of clinicians interviewed were unaware of the presence of a CVC. Unawareness was greatest among patients with PICCs, where 25.1% (60 of 239) of clinicians were unaware of PICC presence. Teaching attendings and hospitalists were more frequently unaware of the presence of CVCs than interns and residents (25.8% and 30.5%, respectively, vs. 16.4%). Critical care physicians were more likely to be aware of CVC presence than general medicine physicians (12.6% vs. 26.2%; P = 0.003). Limitations: Awareness was determined at 1 point in time and was not linked to outcomes. Patient length of stay and indication for CVC were not recorded.Conclusion: Clinicians are frequently unaware of the presence of PICCs and triple-lumen catheters in hospitalized patients. Further study of mechanisms that ensure that clinicians are aware of these devices so that they may assess their necessity seems warranted.

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