[Use and abuse of intravenous catheters in conventional hospital wards]. / Uso y abuso de los catéteres intravenosos en las plantas de hospitalizacion convencional.

ABSTRACT

BACKGROUND: Information regarding the use intravenous catheters (IVC) in conventional hospital units and its consequence in terms of intravenous catéter-related bacteremia (ICRB) is scarce. OBJECTIVES: To evaluate the use of IVC in patients admitted in conventional wards of a general hospital and to measure IVCRB incidence in such patients. METHODS: We evaluated during one week IVC use in adult patients admitted in 12 de Octubre Hospital and we calculated la incidence density of ICRB. RESULTS: We evaluated the clinical charts of 731 patients (284 from medical wards and 447 from surgical wards), of which 338 (46.2%) had a peripheral VC inserted and 63 (8.6%) a central IVC. Central IVC had been inserted for a mean time 11.5 days globally (CI 95% 5.57-17.42), being 28.3 in medical wards and 8.32 days in surgical wards (p = 0.2). In 27.7 % of the patients with IVC intravenous antimicrobials was the only reason for the use of such catheters in spite of adequate oral tolerance in 30 % of the patients with central IVC an specific note explaining the reason for implanting such catheter was lacking in the clinical chart. IVCRB was detected in 12/401 patients (3%). The incidence density of IVCRB in central IVC was 8.28 per 1000 catheter-days. CONCLUSIONS: There are some aspects that could be clearly improved regarding the prevention of IVCRB, mostly in the indications, the excess of time those catheters are kept implanted and in the lost chances for catheter withdrawal when switch-therapy could be performed.