Central Line Catheters
Conditions
Brief summary
The aim of this study is to document clinicians variation in practice in comparison to standard guidelines by the Medical Center's approved Evidence-based Practice (EBP) guidelines, policies, and procedures for Central Venous Catheter(CVC), Peripherally Inserted Central Catheter (PICC), and Hemodialysis (HD catheters by way of a structured retrospective review of the Electronic Medical Record (EMR) system.
Detailed description
This will be a single site retrospective (non-experimental) study utilizing the electronic medical record, both descriptive and correlational methods. There will be two outcomes: 1. The outcomes associated with the management of Central Venous Catheter(CVC), Peripherally Inserted Central Catheter (PICC), and Hemodialysis (HD) Catheter in adherence with hospital approved Evidence-based Practice guidelines for Central Venous Catheter(CVC), Peripherally Inserted Central Catheter (PICC), and Hemodialysis (HD) Catheter. 2. The mechanical/technical, thrombotic, and other adverse outcomes (Heparin induced coagulopathy) associated with central venous catheters due to variation in insertion and management practices of Central Venous Catheter(CVC), Peripherally Inserted Central Catheter (PICC), and Hemodialysis (HD) Catheter.
Interventions
None listed
Sponsors
Hackensack Meridian Health
Study design
Observational model
OTHER
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
22 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• Adult patients in Medical Intensive Care Unit (MICU), Coronary Care Unit (CCU), Cardiac Surgical Intensive Care Unit (CSICU), Surgical Intensive Care Unit (SICU) with either CVCs, PICCs, or HD catheters.
Exclusion criteria
• Pediatric (including neonates), obstetric and gynecology, medical-surgical, and oncology patients.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Adherence to Clinical Guidelines for Catheter Interventions and Management | 1 year | Number of medical records with documented mechanical/technical, thrombotic, and other adverse outcomes associated with use of CVCs, PICCs, and Hemodialysis (HD) catheters. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Documented Catheter Complications | 1 year | Number of medical records with documented complications associated with the use of CVCs, PICCs, and Hemodialysis (HD) catheters |
Countries
United States
Participant flow
Recruitment details
The number of catheters was the focus of the study and because some patients had multiple catheters places, the number of patients does not coincide with the number of catheters.
Participants by arm
| Arm | Count |
|---|---|
| Number of Patients Who Received Hemodialysis Catheters Number of patients who received hemodialysis catheters were reviewed for documentation of variation in practice in comparison to standard guidelines, policies and procedure (note, patients received more than one catheter during hospitalization). | 12 |
| Number of Patients Who Received Peripherally Inserted Peripherally Inserted Central Venous Catheters Number of patients who received Peripherally Inserted Central Venous Catheters (PICC) were reviewed for documentation of variation in practice in comparison to standard guidelines, policies and procedures(note, patients received more than one catheter during hospitalization). | 39 |
| Number of Patients Who Received Central Venous Catheters Number of patients who patients who received Central Venous Catheters (CVC) were reviewed for documentation of variation in practice in comparison to standard guidelines, policies and procedures (note, patients received more than one catheter during hospitalization). | 127 |
| Total | 178 |
Baseline characteristics
| Characteristic | Number of Patients Who Received Hemodialysis Catheters | Number of Patients Who Received Peripherally Inserted Peripherally Inserted Central Venous Catheters | Number of Patients Who Received Central Venous Catheters | Total |
|---|---|---|---|---|
| Age, Continuous | 62.6 years | 68 years | 65.6 years | 65.9 years |
| Race and Ethnicity Not Collected | — | — | — | 0 Participants |
| Sex/Gender, Customized Female | 5 Participants | 23 Participants | 45 Participants | 73 Participants |
| Sex/Gender, Customized Male | 7 Participants | 16 Participants | 82 Participants | 105 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 0 | 0 / 0 | 0 / 0 |
| other Total, other adverse events | 0 / 0 | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 | 0 / 0 |
Outcome results
Primary
Adherence to Clinical Guidelines for Catheter Interventions and Management
Number of medical records with documented mechanical/technical, thrombotic, and other adverse outcomes associated with use of CVCs, PICCs, and Hemodialysis (HD) catheters.
Time frame: 1 year
Population: Medical charts of eligible patients were reviewed and the number of patient medical charts with documentation are summarized. Note, a single patient may have received multiple catheters placed during their hospitalization.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Patients Who Received Hemodialysis Catheters | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented Personnel conducting insertion | 12 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented Fluoroscopy | 4 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented Alcohol impregnated caps used | 0 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented dressing changes | 2 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented Radiological Confirmation of Placement | 11 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented Scrub the hub procedures | 0 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented mask used at dressing change | 0 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented flushes with normal saline | 11 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented procedures accessed for central lines | 0 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented indications for catheter-use | 12 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented syringe sizes used for flushing | 3 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented Catheter Insertion Attempts | 12 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented department/unit locations for Catheter Insertion | 8 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented flushes with heparin lock | 12 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented CUROS caps used | 1 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented CUROS caps used | 0 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented Catheter Insertion Attempts | 0 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented Radiological Confirmation of Placement | 15 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented Fluoroscopy | 0 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented indications for catheter-use | 0 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented department/unit locations for Catheter Insertion | 14 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented Personnel conducting insertion | 0 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented dressing changes | 0 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented mask used at dressing change | 0 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented procedures accessed for central lines | 0 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented Scrub the hub procedures | 0 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented Alcohol impregnated caps used | 0 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented flushes with normal saline | 0 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented flushes with heparin lock | 0 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented syringe sizes used for flushing | 0 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented Personnel conducting insertion | 0 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented flushes with heparin lock | 0 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented Alcohol impregnated caps used | 0 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented department/unit locations for Catheter Insertion | 152 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented indications for catheter-use | 0 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented CUROS caps used | 0 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented Fluoroscopy | 152 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented Catheter Insertion Attempts | 0 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented flushes with normal saline | 0 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented mask used at dressing change | 0 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented Radiological Confirmation of Placement | 0 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented procedures accessed for central lines | 0 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented dressing changes | 0 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented syringe sizes used for flushing | 0 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Adherence to Clinical Guidelines for Catheter Interventions and Management | Number of documented Scrub the hub procedures | 0 # of catheter-related incidents |
Secondary
Number of Documented Catheter Complications
Number of medical records with documented complications associated with the use of CVCs, PICCs, and Hemodialysis (HD) catheters
Time frame: 1 year
Population: Medical charts of eligible patients with HD, PICC, and CVC catheters were reviewed for catheter complications
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Patients Who Received Hemodialysis Catheters | Number of Documented Catheter Complications | Number of documented time of Line insertion | 11 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Number of Documented Catheter Complications | Number of Documented Thrombotic complication | 0 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Number of Documented Catheter Complications | Number of Documented Infection complication type | 0 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Number of Documented Catheter Complications | Number of documented time of Line removal | 12 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Number of Documented Catheter Complications | Number of Documented Thrombotic type | 0 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Number of Documented Catheter Complications | Number of Documented Mechanical complication | 0 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Number of Documented Catheter Complications | Number of Documented Mechanical complication type | 0 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Number of Documented Catheter Complications | Number of Documented Catheter dwell | 0 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Number of Documented Catheter Complications | Number of documented date of Line removal | 12 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Number of Documented Catheter Complications | Number of Documented Infections Complication | 0 # of catheter-related incidents |
| Patients Who Received Hemodialysis Catheters | Number of Documented Catheter Complications | Number of documented date of Line insertion | 12 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Number of Documented Catheter Complications | Number of Documented Mechanical complication | 0 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Number of Documented Catheter Complications | Number of Documented Infections Complication | 0 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Number of Documented Catheter Complications | Number of documented time of Line insertion | 53 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Number of Documented Catheter Complications | Number of documented date of Line removal | 53 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Number of Documented Catheter Complications | Number of documented time of Line removal | 53 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Number of Documented Catheter Complications | Number of Documented Infection complication type | 0 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Number of Documented Catheter Complications | Number of documented date of Line insertion | 53 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Number of Documented Catheter Complications | Number of Documented Thrombotic complication | 0 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Number of Documented Catheter Complications | Number of Documented Mechanical complication type | 0 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Number of Documented Catheter Complications | Number of Documented Thrombotic type | 0 # of catheter-related incidents |
| Patients Who Received Peripherally Inserted Central Venous Catheters (PICC) | Number of Documented Catheter Complications | Number of Documented Catheter dwell | 0 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Number of Documented Catheter Complications | Number of documented time of Line removal | 152 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Number of Documented Catheter Complications | Number of Documented Mechanical complication type | 0 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Number of Documented Catheter Complications | Number of Documented Infections Complication | 0 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Number of Documented Catheter Complications | Number of Documented Infection complication type | 0 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Number of Documented Catheter Complications | Number of Documented Thrombotic complication | 0 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Number of Documented Catheter Complications | Number of Documented Thrombotic type | 0 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Number of Documented Catheter Complications | Number of Documented Catheter dwell | 0 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Number of Documented Catheter Complications | Number of documented date of Line insertion | 152 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Number of Documented Catheter Complications | Number of documented time of Line insertion | 152 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Number of Documented Catheter Complications | Number of documented date of Line removal | 152 # of catheter-related incidents |
| Patients Who Received Central Venous Catheters (CVC) | Number of Documented Catheter Complications | Number of Documented Mechanical complication | 0 # of catheter-related incidents |