Urinary catheters and peripherally inserted central catheters (PICCs) are medical devices commonly used in hospitals and are important for the care and management of many patients. However, both devices are also associated with important and potentially life-threatening complications. One of the most well-known complications is infection but other types of complications can also occur. Unfortunately, the full range of potential complications or the longer-term consequences of these complications is currently unknown. In addition, because of this gap in our knowledge, important opportunities for improving safety and reducing potential harm to Veteran and non-Veteran patients are yet to be identified and implemented. The purpose of this multi-site study is to identify, better understand, and then develop strategies to address the full range of complications - infectious and non-infectious - associated with the use of urinary catheters and PICCs.
Study specific aims are: 1) To determine the type and frequency of complications associated with the use of urinary catheters (primarily indwelling urethral catheters) from insertion up to 90 days for patients in acute care settings and Veterans Health Administration (VHA) community living centers. 2) To determine the type and frequency of complications associated with the use of PICCs from insertion up to 90 days for patients in acute care settings and VHA community living centers. 3) To identify factors (patient, provider or device) associated with complications from the use of urinary catheters and PICCs. 4) To develop and pilot test at least one strategy to reduce urinary catheter-related complications and one strategy to reduce PICC-related complications. The proposed study will use a prospective observational design in which hospitalized patients at four medical centers who have either a urinary catheter or a PICC placed will be identified and after they agree to participate will be followed for 90 days post-insertion. Information about both infectious and non-infectious device-related complications during this 90-day period will be collected from the medical record as well as by patient self-report, through a series of brief assessments and interviews. Data collected as part of this study will also be used to develop and pilot test at least one strategy for reducing urinary catheter related complications and one strategy to reduce complications from PICCs. Reducing preventable harms from medical care is a national imperative. This study will provide critical information to help further reduce the occurrence of preventable hospital-acquired conditions and thereby improve care for both hospitalized Veteran and non-Veteran patients.
Certain medical devices - such as urinary catheter and peripherally inserted central catheters (PICCs) - are frequently used in the hospital setting. Although both urinary catheters and PICCs are important for the medical management of many patients, they can also cause serious and potentially life-threatening complications. At present, however, there is not sufficient information about the full range of complications or the long-term effect on patients who experience these events. This study will provide critical information about the complications associated with urinary catheters and PICCs and help to identify and test strategies to prevent or reduce the occurrence of these complications. As such, the findings of his multicenter study will have a direct impact on the safety and well-being of Veteran and non-Veteran patients.