Impact of delirium and suture-less securement on accidental vascular catheter removal in the ICU

The objectives were to describe the incidence of accidental vascular catheter removal (AVCR) in an Australian Intensive Care Unit (ICU) and evaluate whether the fixation method or patient delirium increased the risk of AVCR. This prospective observational study was based in a tertiary level ICU betw...

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Bibliographic Details
Published in:Anaesthesia and intensive care 2014-07, Vol.42 (4), p.473-479
Main Authors: Sundararajan, K, Wills, S, Chacko, B, Kanabar, G, O'Connor, S, Deane, A M
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Australia - epidemiology
Catheterization, Central Venous - instrumentation
Catheterization, Central Venous - methods
Catheters - statistics & numerical data
Causality
Child
Child, Preschool
Critical Care - methods
Critical Care - statistics & numerical data
Delirium - epidemiology
Female
Humans
Incidence
Infant
Intensive Care Units - statistics & numerical data
Male
Middle Aged
Odds Ratio
Postoperative Complications - epidemiology
Prospective Studies
Risk Factors
Suture Techniques - instrumentation
Suture Techniques - statistics & numerical data
Young Adult
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Summary:The objectives were to describe the incidence of accidental vascular catheter removal (AVCR) in an Australian Intensive Care Unit (ICU) and evaluate whether the fixation method or patient delirium increased the risk of AVCR. This prospective observational study was based in a tertiary level ICU between April 2011 and October 2012. All vascular catheters were secured either by sutures or by a suture-less securement device (STATLOCK(™), Bard Medical, Covington, GA, USA) as per the treating clinician. Data were obtained from bedside nursing staff, with daily screening for delirium completed by the ICU medical team using the Confusion Assessment Method-ICU. 2361 patients were admitted during this period with 1032 patients screened and data available for 322 patients (452 vascular catheters). AVCR occurred in 15 patients (16 vascular catheters) (5.0%) with an incidence of AVCR of 2.77 per 100 catheter-days. Delirious patients were 13-fold more likely to have an AVCR event (odds ratio=13.3; 95% confidence interval 4.36, 40.52; P
ISSN:0310-057X
1448-0271
DOI:10.1177/0310057x1404200408