A Prospective Survey of Accidental Catheter and Tube Removal in a Surgical Intensive Care Unit

Objective: Unplanned catheter removal (UCR) in the surgical intensive care unit (sICU) can result in insufficient treatment or monitoring of patients. Our aim was to evaluate the frequency and clinical features of UCRs in sICU patients. Material and Methods: This prospective observational study was run in a 16-bed sICU from 19/09/2009 through 02/03/2010. Four researchers observed the study. The staff in sICU was unaware of observation. Every UCR were classified as either a patient-related incident or health care staff-related incident. Both vascular and non-vascular UPRs were included. A comparison was made between conditions with (pts:≥8) and without (pts:≤7) heavy workload in sICU. Results: Six hundred and eight patients were observed in 1291 patient days. Overall, 92 (6.2%) incidents were recorded. Of these, 72 (4.8%) were patient-related and 20 (1.3%) health care staff-related catheter and tube removals. UCRs occurred more frequently on days with heavy workload compared to other days (9.6% v.s. 3.1%; p 0.001). Subgroup analysis revealed that peripheral vein catheters (p=0.008) and non-vascular tubes (p 0.001) were more likely to be accidentally removed on days with heavy workload compared to other days. Conclusion: Unplanned catheter removal in sICU is prevalent to the extent that it requires close monitoring. Our results suggest that the likelihood of accidental removal increases on days when a high number of patients are admitted.