CQI: Ordering the

Correct Central
Venous Catheter
By Jessica Meyers
Team to Be Involved

Resident- One of the residents in the department works with physicians

throughout the hospital and within the department for add-ons
Physician/fellow- the physician or fellow would be the one implanting the
central venous catheter and will know which catheter is best for the
patients needs
Interventional technologist- the technologist will know which catheters are
in stock and which catheters will work for what the physician is requesting
Ordering physician- works with the patient more regularly and will know the
needs of the patient
Problem Within the Department

Ordering physicians are filling out the questionnaire for CVCs and then
specifying a CVC that does not match
Under reason for exam in chart and on req

Patient is sent for, tech notices error, delay in patient care

Causes for Problem

Poor communication
Lack of education on catheters available

Have monthly or biweekly meetings

Tech in charge
Proposed Plan

Continue to provide ordering physicians with the questionnaire

How long will it be needed?
What will it be used for?

Do not provide them the ability to specify a catheter of choice

Resident follows a guideline when putting in add-ons
Technologist verifies with fellow/physician, during timeout, the catheter
to be used
Action
Technologist
Educate incoming residents and hold biweekly meeting for updates
Verify catheter with physician during timeout

Resident
Follow guideline and verify questionable catheters with VIR physician
each morning before patients come down
Physician
Meet with technologist and stay updated on available catheters
Ensure residents are educated

Ordering physician
Send feedback to VIR physician each time a patient gets wrong catheter
Methods
Technologist
Meeting sign-in sheets and documentation of orientation for new residents
Document if physician changes catheter during timeout
Log delay in care (patient arriving to start of procedure)

Resident
Document catheters approved by physician and include which physician

Physician
Collect documented changes and delay in care logs from technologist
Give feedback to residents weekly (sooner for more concerning problems)

Ordering physician
Notification to VIR physician with catheter that was placed and why it wasnt
right
Determining Success

Patient care is not delayed

No need to call ordering physician and have them put in new order
Decrease in number of delay of care procedures in log

Patient gets correct catheter for all of their needs

Decrease in feedback from ordering physicians

Plan could be adapted and continued for other procedures