Analysis of catheter utilization, central line associated bloodstream infections, and costs associated with an inpatient critical care-driven vascular access model

Madhuri Tirumandas, Inessa Gendlina, Jamie Figueredo, Ariel L. Shiloh, Polina Trachuk, Ruchika Jain, Marilou Corpuz, Brian D. Spund, Aloke Maity, Dmitriy Shmunko, Melba Garcia, Diahann Barthelemy, Gregory Weston, Theresa F. Madaline

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Central line-associated bloodstream infections (CLABSI) carry serious risks for patients and financial consequences for hospitals. Avoiding unnecessary temporary central venous catheters (CVC) can reduce CLABSI. Critical Care Medicine (CCM) is often consulted to insert CVC when alternatives are unavailable. We aim to describe clinical and financial implications of a CCM-driven vascular access model. Methods: In this retrospective, observational cohort study, all CLABSI and a sample of CCM consults for CVC insertion on adult medical-surgical inpatient units were reviewed in 2019. Assessment of CVC appropriateness and financial analysis of labor, reimbursement, and attributable CLABSI cost was conducted. Results: Of 554 CCM consult requests, 75 (13.5%) were for CVC and 36 (48.0%) resulted in CVC insertion; 6 (16.7%) CVC were avoidable. Three CLABSI occurred in avoidable CVC with estimated annual attributable cost of $165,099. Estimated annual CCM consultant cost for CVC was $78,094 generating $110,733 in reimbursement. Overall estimated annual loss was $132,460. Discussion: Reliance on CCM for intravenous access resulted in avoidable CVC, CLABSI, inefficient physician effort, and financial losses; nurse-driven vascular access models offer potential cost savings and risk reduction. Conclusions: CCM-driven vascular access models may not be cost-effective; alternatives should be considered for utilization reduction, CLABSI prevention, and financial viability.

Original languageEnglish (US)
JournalAmerican Journal of Infection Control
DOIs
StateAccepted/In press - 2020

Keywords

  • Central line associated sepsis
  • Central venous catheter
  • CLABSI
  • Critical Care Medicine
  • Hospital acquired infection

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Fingerprint Dive into the research topics of 'Analysis of catheter utilization, central line associated bloodstream infections, and costs associated with an inpatient critical care-driven vascular access model'. Together they form a unique fingerprint.

Cite this