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Date of Graduation

8-2007

Degree Type

Capstone Project (On-Campus Access Only)

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Hector Camacho, PA-C

Second Advisor

Jonathon W. Gietzen MS PA-C

Abstract

Background: Central venous catheters are a special type of intravenous catheter (tube), which are usually inserted in the operating room, intensive care unit, emergency department, or catheter lab. They are threaded through a vein in the neck (the external or internal jugular vein) or a vein in the upper chest under the collar bone (the subclavian vein) into a large central vein in the superior vena cava. There are two general types of catheters, those that are permanently placed under the skin with no catheter coming out through the skin (an internal catheter), or those that come out through the skin (the external catheter). Purpose of the Study: The purpose of the study is to determine the prevalence of infections (localized and systemic) in subjects who have central venous catheters placed by Interventional Radiologists. Methods: This is a chart review survey; therefore access to physician portal electronic charts, as well as any pertinent paper records was reviewed. The only data that will be collected are their age, gender, procedure being performed, prior procedures, reason for procedure, and length of hospital stay. Results: During a 2-month period 135 patients at Providence Portland Medical Center received a central venous catheter; 95 (70%) new right internal jugulars (IJs); 25 (19%) new left Us; 4 (3%) replacement right Us; 2 (1.5%) replacement left Us; 4 (3%) new subclavian, 1 (0.7%) replacement subclavian; 2 (1.5%) new left groins; 1 (0.7%) new left external jugular (EJ), and 1 (0.7%) new right EJ. Ofthe 135 patients 9 (6%) infections occurred. 2 (22%) left groins were infected with Staph aureus/Gram pos cocci and 7 (78%) right Us were infected with Coagulase negative-staphylococci. Conclusion: It is inconclusive to affirm that surgically placed CVCs by Interventional Radiologists are the solitary cause of infections. And even though an infection may occur within 30 days, which is the time that Interventional Radiologist consider fault, there is a flowchart of health care workers (nurses, technicians, dieticians, etc.) that intervene with the patients skin and catheter hub.

Comments

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