OPTIMAL INTERVAL FOR TRIPLE-LUMEN CATHETER CHANGES - A DECISION-ANALYSIS

A survey of 53 university and community hospitals revealed that 73% of the institutions had no standard policy for the replacement of triple -lumen catheters (TLCs). Since the maintenance of a TLC in place for a prolonged period may lead to infectious complications, it appeared wa rranted that standards of management be developed. A decision-tree mod el was constructed for evaluating the optimal time for changing a TLC that would minimize infection. Cost estimates and health effects at th ree-, five-, and ten-day change intervals were considered for catheter insertion and complications resulting from such insertion. The result s suggested that prophylactic catheter changes should occur no later t han every five days, provided that there are no signs of infection. Ho wever, sensitivity analysis of several variables suggested that indivi dual institutions should establish policy timing changes based upon ca reful interpretation of their own data. A model was developed to assis t in determining the optimal time to change a TLC based upon such data .