90% of Clinicians Unaware of Central Venous Catheters

According to a recent study, 21.2% of clinicians were unaware that their patients were hospitalized with a central venous catheter including a peripherally inserted central catheter (PICC) and triple-lumen catheters.

For the study, 425 clinicians from 3 academic medical centers in the US were interviewed between April 2012 and September 2013 about the presence of central venous catheters (CVC) in their patients.
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Researchers also evaluated 990 patients in the intensive care unit (ICU) and other settings and administered physical exams to search for PICCs or triple lumen catheters.

Overall, 21.1% of the 990 patients had CVCs and 60.3% of those were were PICC lines.

Of the 425 clinicians, 90% were unaware that their patients had CVC’s and 5.6% of clinicians thought their patients had a CVC when they did not. Almost 13.8% of medical residents were unaware of CVC presence, and 19.1% of interns had no knowledge of the catheters. Hospitalists (30.5%) and medical teaching attendings (25.8%) were more unaware of CVCs than house staff members (16.4%).

Researchers found that critical care physicians who tend to place CVCs in patients had a greater awareness than general physicians: 12.6% and 26.2%, respectively.

“Certain aspects of daily work rounds essential to preventing avoidable harms should be scripted so that they are heard at each ‘performance’ of patient care,” said Darren B. Taichman, MD, PhD in an accompanying editorial.

“Ultimately, however, we know that reminders and alarms frequently go unheeded or ignored. We have all seen forms nicely completed by clinicians who lack mindfulness of many or even all of pertinent positives and negatives needed to understand the care of the patient. But, providing a script here will not be enough,” he said.

The complete study is published in the October issue of Annals of Internal Medicine.

-Michelle Canales

References:

Chopra V, Govindan S, Kuhn L, et al. Do clinicians know which of their patients have central venous catheters. Ann Intern Med. 2014 October [epub ahead of print] doi: 10.7326/M14-0703.

Taichman DB. Whose line is it anyway? Ann Intern Med. 2014 October [epub ahead of print] doi: 10.7326/M14-2005.