Retained Guidewires

Inserting a central venous catheter is a commonly performed invasive procedure. While much attention has been paid to the risk of blood borne infections as a consequence of using catheters, little notice has been made of another risk: during the placement of these catheters, the guidewire used can be left behind in the patient. The purpose of this study is to explore this complication using data collected by the Veterans Health Administration (VHA) at its 151 hospitals and clinics.

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Evaluation of operating room suite efficiency in the Veterans Health Administration system by using data-envelopment analysis

The American Journal of Surgery ◽

10.1016/j.amjsurg.2006.07.005 ◽

2006 ◽

Vol 192 (5) ◽

pp. 649-656 ◽

Cited By ~ 25

Author(s):

Marc D. Basson ◽

Timothy Butler

Keyword(s):

Data Envelopment Analysis ◽

Operating Room ◽

Veterans Health Administration ◽

Data Envelopment ◽

Veterans Health ◽

Health Administration ◽

Administration System ◽

Using Data

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Incidence of Clostridioides difficile infections among young and middle-aged adults: Veterans Health Administration

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2019.160 ◽

2019 ◽

Vol 40 (9) ◽

pp. 997-1005 ◽

Cited By ~ 1

Author(s):

Ellyn M. Russo ◽

Jennifer Kuntz ◽

Holly Yu ◽

Jeremy Smith ◽

Ronald George Hauser ◽

...

Keyword(s):

Veterans Health Administration ◽

Health Concern ◽

Charlson Comorbidity Index Score ◽

Veterans Health ◽

Health Administration ◽

Middle Aged ◽

Clostridioides Difficile ◽

Using Data ◽

Middle Aged Adult

AbstractObjective:Clostridioides difficile infection (CDI) remains a significant public health concern, resulting in excess morbidity, mortality, and costs. Additional insight into the burden of CDI in adults aged <65 years is needed.Design/Setting:A 6-year retrospective cohort study was conducted using data extracted from United States Veterans Health Administration electronic medical records.Patients/Methods:Patients aged 18–64 years on January 1, 2011, were followed until incident CDI, death, loss-to-follow-up, or December 31, 2016. CDI was identified by a diagnosis code accompanied by metronidazole, vancomycin, or fidaxomicin therapy, or positive laboratory test. The clinical setting of CDI onset was defined according to 2017 SHEA-IDSA guidelines.Results:Of 1,073,900 patients, 10,534 had a CDI during follow-up. The overall incidence rate was 177 CDIs per 100,000 person years, rising steadily from 164 per 100,000 person years in 2011 to 189 per 100,000 person years in 2016. Those with a CDI were slightly older (55 vs 51 years) and sicker, with a higher baseline Charlson comorbidity index score (1.4 vs 0.5) than those without an infection. Nearly half (48%) of all incident CDIs were community associated, and this proportion rose from 41% in 2011 to 56% in 2016.Conclusions:The findings from this large retrospective study indicate that CDI incidence, driven primarily by increasing community-associated infection, is rising among young and middle-aged adult Veterans with high service-related disability. The increasing burden of community associated CDI in this vulnerable population warrants attention. Future studies quantifying the economic and societal burden of CDI will inform decisions surrounding prevention strategies.

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Encountering the unexpected: A left behind part of ICD leads causing difficulty in insertion of guidewire of central venous catheter

Revista Argentina de Anestesiología ◽

10.1016/j.raa.2016.06.002 ◽

2016 ◽

Vol 74 (1) ◽

pp. 36-39

Author(s):

Pradipta Bhakta ◽

Vikash Singh ◽

Ashfaq Hussain ◽

Edyta Zietak

Keyword(s):

Central Venous Catheter ◽

Venous Catheter ◽

Central Venous ◽

Left Behind ◽

Icd Leads

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Depth of Central Venous Catheter Insertion in Adults: An Audit and Assessment of a Technique to Improve Tip Position

Anaesthesia and Intensive Care ◽

10.1177/0310057x9802600109 ◽

1998 ◽

Vol 26 (1) ◽

pp. 61-66 ◽

Cited By ~ 33

Author(s):

G. A. Chalkiadis ◽

C. R. Goucke

Keyword(s):

Central Venous Catheter ◽

Standard Technique ◽

Venous Catheter ◽

Right Atrial ◽

Central Venous ◽

Cardiac Anaesthesia ◽

Tip Position ◽

Using Data ◽

The Individual ◽

The Right

A technique of subclavian vein catheterization is described, tailored to the individual patient, to reduce the risk of right atrial placement with central venous catheter (CVC) insertion. Using data gathered retrospectively for Quality Improvement purposes, CVC tip location was assessed. The standard technique used in our cardiac anaesthesia unit at that time was to insert all CVCs to a depth of 15 cm from the skin. We then compared CVC tip location using a new “tailored” technique. The tailored method involved measuring the distance from the skin at which venepuncture occurred and using this distance to determine depth of CVC insertion. Using the tailored technique significantly decreases the frequency with which CVC tips enter the right atrium (P<0.001). An advantage of the tailored technique is that the distance between the most proximal and the distal ports of multi-lumen CVCs is taken into consideration, reducing the risk of extravasation via the proximal port.

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An Intervention With Meaning

Crisis ◽

10.1027/0227-5910/a000433 ◽

2017 ◽

Vol 38 (6) ◽

pp. 376-383 ◽

Cited By ~ 2

Author(s):

Brooke A. Levandowski ◽

Constance M. Cass ◽

Stephanie N. Miller ◽

Janet E. Kemp ◽

Kenneth R. Conner

Keyword(s):

High Risk ◽

Qualitative Methodology ◽

Veterans Health Administration ◽

Veterans Health ◽

Safety Planning ◽

Health Administration ◽

Suicide Method ◽

Treatment Providers ◽

Interactive Nature ◽

Behavioral Health Treatment

Abstract. Background: The Veterans Health Administration (VHA) health-care system utilizes a multilevel suicide prevention intervention that features the use of standardized safety plans with veterans considered to be at high risk for suicide. Aims: Little is known about clinician perceptions on the value of safety planning with veterans at high risk for suicide. Method: Audio-recorded interviews with 29 VHA behavioral health treatment providers in a southeastern city were transcribed and analyzed using qualitative methodology. Results: Clinical providers consider safety planning feasible, acceptable, and valuable to veterans at high risk for suicide owing to the collaborative and interactive nature of the intervention. Providers identified the types of veterans who easily engaged in safety planning and those who may experience more difficulty with the process. Conclusion: Additional research with VHA providers in other locations and with veteran consumers is needed.

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