Journal Article

Use of Maximal Sterile Barriers during Central Venous Catheter Insertion: Clinical and Economic Outcomes

Kent K. Hu, David L. Veenstra, Benjamin A. Lipsky and Sanjay Saint

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 39, issue 10, pages 1441-1445
Published in print November 2004 | ISSN: 1058-4838
Published online November 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/425309
Use of Maximal Sterile Barriers during Central Venous Catheter Insertion: Clinical and Economic Outcomes

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  • Infectious Diseases
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Background. We performed a cost-effectiveness analysis to determine the effect of maximal sterile barriers (MSBs) on reducing central venous catheter (CVC)—related infections. Use of MSBs when placing CVCs may reduce the risk of infections but is more cumbersome, time-consuming, and expensive than other techniques.

Methods. We developed a decision analytic model in which a patient could have a CVC placed with either an MSB or a less stringent technique. We calculated total direct medical costs and the incidences of catheter-related bloodstream infections, catheter colonization, and death.

Results. Use of MSBs lowered costs (from $621 to $369 per catheter insertion) and decreased the incidences of catheter-related bloodstream infections (from 5.3% to 2.8%), catheter colonization with local infection (from 5.5% to 2.9%) and death (from 0.8% to 0.4%). MSBs improved patient safety throughout all sensitivity analyses.

Conclusions. Use of MSBs during CVC insertion likely lowers medical costs and decreases the incidences of catheter colonization, catheter-related bloodstream infections, and death. Cost savings were found over a wide range of clinical and economic assumptions, suggesting that MSBs should be routinely used when CVCs are inserted.

Journal Article.  2760 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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