Comparison of Routine Replacement With Clinically Indicated Replacement of Peripheral Intravenous Catheters
| Autor: | Mohamed Abbas, Marlieke E. A. de Kraker, Daniel Teixeira, Walter Zingg, Stéphan Juergen Harbarth, Julien Sauser, Didier Pittet, Valérie Sauvan, Niccolò Buetti, Marie-Noëlle Chraïti |
|---|---|
| Přispěvatelé: | University of Zurich, Buetti, Niccolò |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Catheters Peripheral intravenous 610 Medicine & health Hospitals University 10234 Clinic for Infectious Diseases Catheters Indwelling Interquartile range Patient age Internal medicine Catheterization Peripheral Internal Medicine medicine Humans Adverse effect Device Removal Original Investigation Duration of Therapy business.industry Incidence Incidence (epidemiology) Middle Aged Catheter Outcome and Process Assessment Health Care 2724 Internal Medicine Peripheral intravenous catheters Catheter-Related Infections Practice Guidelines as Topic Female Guideline Adherence business Switzerland Cohort study |
| Zdroj: | JAMA Intern Med |
| Popis: | IMPORTANCE: Peripheral intravenous catheters (PVCs) are the most frequently used indwelling devices in hospitals worldwide. Peripheral intravenous catheter bloodstream infections (PVC-BSIs) are rare, but severe and preventable, adverse events. OBJECTIVE: To investigate the incidence of PVC-BSIs after changing the policy of routine PVC replacement every 96 hours to clinically indicated replacement. DESIGN, SETTING, AND PARTICIPANTS: This institution-wide, observational cohort study evaluated all patients hospitalized at a large university-affiliated hospital with 10 sites in Western Switzerland with a PVC insertion between January 1, 2016, and February 29, 2020. EXPOSURES: Peripheral intravenous catheters were routinely replaced every 96 hours until March 31, 2018 (baseline period). Between April 1, 2018, and October 15, 2019, PVCs were replaced if clinically indicated (intervention period). From October 16, 2019, PVCs were again routinely replaced every 96 hours (reversion period). MAIN OUTCOMES AND MEASURES: The PVC-BSI rates and PVC-BSI incidence rate ratios (IRRs) during each period. RESULTS: A total of 412 631 PVCs with documented catheter duration were included (164 331 patients; median [interquartile range] patient age, 51 [33-72] years; 88 928 [54.1%] female): 241 432 PVCs at baseline, 130 779 at intervention, and 40 420 at reversion. Eleven PVC-BSIs were observed during the baseline period, 46 during the intervention, and 4 during the reversion period. Although the monthly number of PVC-days remained stable during all study periods, the number of monthly inserted PVCs decreased during the intervention period. The number of PVCs still in place more than 4 or more than 7 days was higher during the intervention period compared with the baseline and reversion periods. A significantly increased IRR of PVC-BSIs was observed for the intervention period (IRR, 7.20; 95% CI, 3.65-14.22; P |
| Databáze: | OpenAIRE |
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