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; Sanjay Saint, MD, MPH
Acknowledgment: The authors thank Drs. Anneliese Schleyer, Melissa Teply, Shinie Kuo, Prakash Shrestha and Beth Brenner; Ms. Carol Becker; and Ms. Christina Healy for assisting with data collection.
Financial Support: Dr. Chopra was supported by a career development award (1-K08-HS022835-01) from the Agency for Healthcare Research and Quality.
Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-0703.
Reproducible Research Statement:Study protocol: Not available. Statistical code and data set: Available from Dr. Chopra (e-mail, firstname.lastname@example.org).
Requests for Single Reprints: Vineet Chopra, MD, MSc, Veterans Affairs Ann Arbor Healthcare System, 2800 Plymouth Road, Building 16, Room 432W, Ann Arbor, MI 48109; e-mail, email@example.com.
Current Author Addresses: Dr. Chopra: Veterans Affairs Ann Arbor Healthcare System, 2800 Plymouth Road, Building 16, Room 432W, Ann Arbor, MI 48109.
Dr. Govindan: University of Michigan Health System, 1500 East Medical Center Drive, SPC 5376, Ann Arbor, MI 48109.
Ms. Kuhn: Health Services Research and Development, 2800 Plymouth Road, Building 16, 4th Floor, Ann Arbor, MI 48105.
Mr. Ratz: Health Services Research and Development, 2800 Plymouth Road, Building 16, 3rd Floor, Ann Arbor, MI 48109-2800.
Dr. Sweis: University of Chicago, 5841 South Maryland Avenue, MC 2115, Chicago, IL 60637.
Ms. Melin and Dr. Thompson: Harborview Medical Center, Box 359780, Seattle, WA 98104.
Dr. Tolan: Spectrum Health System, Resident Program, 25 Michigan Street NE, Suite 2200, Grand Rapids, MI 49503.
Dr. Barron: Department of Hospital Medicine, Spectrum Health System, 100 Michigan Street NE, Suite A-721, Grand Rapids, MI 49503.
Dr. Saint: Veterans Affairs Ann Arbor Healthcare System, 2800 Plymouth Road, Building 16, Room 430W, Ann Arbor, MI 48109.
Author Contributions: Conception and design: V. Chopra, S. Govindan, R.F. Sweis, R. Thompson, J. Barron, S. Saint.
Analysis and interpretation of the data: V. Chopra, S. Govindan, L. Kuhn, D. Ratz, R.F. Sweis, N. Melin, R. Thompson, J. Barron, S. Saint.
Drafting of the article: V. Chopra, S. Govindan, L. Kuhn, D. Ratz, R.F. Sweis, J. Barron.
Critical revision of the article for important intellectual content: V. Chopra, R.F. Sweis, R. Thompson, J. Barron, S. Saint.
Final approval of the article: V. Chopra, S. Govindan, L. Kuhn, R.F. Sweis, N. Melin, R. Thompson, J. Barron, S. Saint.
Provision of study materials or patients: V. Chopra, R.F. Sweis, R. Thompson, J. Barron.
Statistical expertise: V. Chopra, D. Ratz.
Obtaining of funding: V. Chopra.
Administrative, technical, or logistic support: V. Chopra, S. Govindan.
Collection and assembly of data: V. Chopra, S. Govindan, L. Kuhn, R.F. Sweis, N. Melin, R. Thompson, J. Barron.
Chopra V, Govindan S, Kuhn L, Ratz D, Sweis RF, Melin N, et al. Do Clinicians Know Which of Their Patients Have Central Venous Catheters?: A Multicenter Observational Study. Ann Intern Med. 2014;161:562-567. doi: 10.7326/M14-0703
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Published: Ann Intern Med. 2014;161(8):562-567.
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.
To assess how often clinicians were unaware of the presence of triple-lumen catheters or peripherally inserted central catheters (PICCs) in hospitalized patients.
Multicenter, cross-sectional study.
3 academic medical centers in the United States.
Hospitalized medical patients in intensive care unit (ICU) and non-ICU settings.
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.
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).
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.
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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Hospital Medicine, Pulmonary/Critical Care.
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