Should the CDC’s recommendations for promptly removing unnecessary centrally inserted central catheters be enhanced? Ultrasound-guided peripheral venous cannulation to fully comply

Abstract

Purpose: In an effort to reduce catheter-related bloodstream infection’s incidence rates in an intensive care unit, several evidence-based procedures recommended by the Centers for Disease Control and Prevention for centrally inserted central catheters were implemented. A failure to fully comply with the recommendation for prompt removal of the centrally inserted central catheters was attributed, mainly to the difficulties and inadequacies raised from establishing peripheral venous access. Methods: The ultrasound-guided peripheral venous cannulation method as a supplementary intervention to the Centers for Disease Control and Prevention’s recommendations was incorporated and examined during the subsequent year. Results: A significant reduction on catheter-related bloodstream infection incidence rates out of the expected range was found. Centrally inserted central catheters utilization ratios were reduced by 10.7% (p < 0.05; 58%–47%) and the catheter-related bloodstream infection incidence rate was reduced by 11.7 per thousand device–days (15.9–4.16/1000 centrally inserted central catheters days (2015–2016 group, respectively)). Conclusion: The reduction of catheter-related bloodstream infection was higher than that described in the published literature. This probably shows that the combination of the five evidence-based procedures recommended by the Centers for Disease Control and Prevention together with that of ultrasound-guided peripheral venous cannulation method can increase the compliance with the Category IA recommendation for removal or avoidance of unnecessary placement of centrally inserted central catheters and decrease the catheter-related bloodstream infections in a more effective way, by affecting the patients’ centrally inserted central catheter exposure.