title: Temporary central venous catheter utilization patterns in a large tertiary care center: tracking the "idle central venous catheter".
abstract: OBJECTIVE
  Although central venous catheter (CVC) dwell time is a major risk factor for catheter-related bloodstream infections (CR-BSIs), few studies reveal how often CVCs are retained when not needed ("idle"). We describe use patterns for temporary CVCs, including peripherally inserted central catheters (PICCs), on non-ICU wards.
  
  
  METHODS
  A retrospective observational study.
  
  
  METHODS
  A 579-bed acute care, academic tertiary care facility.
  
  
  METHODS
  A retrospective observational study of a random sample of patients on hospital wards who have a temporary, nonimplanted CVC, with a focus on on daily ward CVC justification. A uniform definition of idle CVC-days was used.
  
  
  RESULTS
  We analyzed 89 patients with 146 CVCs (56% of which were PICCs); of 1,433 ward CVC-days, 361 (25.2%) were idle. At least 1 idle day was observed for 63% of patients. Patients had a mean of 4.1 idle days and a mean of 3.4 days with both a CVC and a peripheral intravenous catheter (PIV). After adjusting for ward length of stay, mean CVC dwell time was 14.4 days for patients with PICCs versus 9.0 days for patients with non-PICC temporary CVCs (other CVCs; P<.001). Patients with a PICC had 5.4 days in which they also had a PIV, compared with 10 days in other CVC patients (P<.001). Patients with PICCs had more days in which the only justification for the CVC was intravenous administration of antimicrobial agents (8.5 vs 1.6 days; P=.0013).
  
  
  CONCLUSIONS
  Significant proportions of ward CVC-days were unjustified. Reducing "idle CVC-days" and facilitating the appropriate use of PIVs may reduce CVC-days and CR-BSI risk.
authors.affiliation: Division of Hospital Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia 30322, USA. scherne@emory.edu
authors.forename: Sheri Chernetsky
authors.initials: SC
authors.lastname: Tejedor
authors.forename: David
authors.initials: D
authors.lastname: Tong
authors.forename: Jason
authors.initials: J
authors.lastname: Stein
authors.forename: Christina
authors.initials: C
authors.lastname: Payne
authors.forename: Daniel
authors.initials: D
authors.lastname: Dressler
authors.forename: Wenqiong
authors.initials: W
authors.lastname: Xue
authors.forename: James P
authors.initials: JP
authors.lastname: Steinberg
mesh_terms: D000328:Adult; D000368:Aged; D055499:Catheter-Related Infections / Q000209:etiology* / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000706:statistics & numerical data*; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D003428:Cross Infection / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013997:Time Factors