See How Neutron Can Help You Make a Real Difference Clinically and Financially

This simple-to-use calculator will help you better understand the financial impact of central line catheter occlusions on your institution. Neutron can help reduce these costs by helping to reduce the overall incidence of central line catheter occlusions.

Costs of Central Line Catheter Occlusions

The direct economic costs of routine occlusions can be significant. Once a nurse has identified an occlusion and has ruled out mechanical or chemical causes, treatment with a thrombolytic agent is usually attempted. Each attempt to restore catheter patency using a de-clotting agent such as tissue plasminogen activator (tPA) can cost $120,1 but the true operational cost is much higher. Considering supply costs and time spent reconstituting the therapeutics, the cost to address an occlusion can quickly reach $206 per treatment.2

Patency restoration utilizing tPA is successful in 73.9% to 89.9% of cases.3 When tPA is unsuccessful, the cost of device replacement greatly exceeds that of salvage and can include costs for interventional radiology, diagnostic imaging, nursing, supplies, and, of course, a new access device. Catheter occlusion is the most common non-infectious complication in long-term use of central venous access devices (CVADs). Total published cost estimates of central venous catheter (CVC) and peripheral inserted central catheter (PICC) replacement varies widely from $850–$1,500, depending on the type of CVC,1,4 to $200–$3,000 for PICC lines, depending on the care setting and need for interventional radiology.3 In addition, interruption of clinically necessary therapies and medication administration during the patency restoration process has been shown to compromise patient care and lead to an increased length of stay.5,6,7-10 Hospital-adjusted expenses per inpatient day in the United States range between $985 in South Dakota to $2,696 in Washington State, with the national average cost per inpatient day being $1,853 per day.11

 

 

References

  1. Kokotis K. Cost containment and infusion services. Journal of Infusion Nursing. (2005) 28(3 Suppl.), S22-S32.
  2. Ryder M. The role of biofilm in vascular catheter-related infections. N Dev Vasc Dis. 2001;2:15-25.
  3. O’Grady NP, Alexander M, Dellinger EP, et al. Guidelines for the prevention of intravascular catheter-related infections. MMWR Recomm Rep. 2002;51(RR-10):1-26.
  4. Cummings-Winfield C, Mushani-Kanji T. Restoring patency to central venous access devices. Clin J Oncol Nurs. 2008; 12(6):925-934.
  5. Maki DG, Mermel LA, Kluger D, Narins L, Knasinski V, Parenteau S. The Efficacy of a Chlorhexidine-Impregnated Sponge (BiopatchTM) for the Prevention of Intravascular Catheter-Related Infection: A Prospective, Randomized, Controlled, Multicenter Study. Washington, DC: American Society for Microbiology; 2000.
  6. Kokotis K. Cost containment and infusion services. Journal of Infusion Nursing. (2005) 28(3 Suppl.), S22-S32.
  7. Timoney JP, Malkin MG, Leone DM, Groeger JS, Heaney ML, Keefe DL, Klang M, Lucarelli CD, Muller RJ, Eng SL, Connor M, Small TN, Brown AE, Saltz LB. Safe and cost effective use of alteplase for the clearance of occluded central venous access devices, JCO. Apr 1, 2002:1918-1922; DOI:10.1200/JCO.2002.07.131.
  8. Ponec D, Irwin D, Haire WD, Hill PA, Li X, McCluskey ER; COOL Investigators. Recombinant tissue plasminogen activator (alteplase) for restoration of flow in occluded central venous access devices: a double-blind placebo-controlled trial—the Cardiovascular Thrombolytic to Open Occluded Lines (COOL) efficacy trial. J Vasc Interv Radiol. 2001 Aug;12(8):951-5.
  9. Cummings-Winfield C, Mushani-Kanji T. Restoring patency to central venous access devices. Clin J Oncol Nurs. 2008; 12(6):925-934.
  10. Wingerter L. Vascular access device thrombosis. Clin J Oncol Nurs. 2003;7(3):345-348.
  11. Camp-Sorrell D, ed. Access Device Guidelines: Recommendations for Nursing Practice and Education. 2nd ed. Pittsburgh, PA: Oncology Nursing Society; 2004.