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An Audit

Charles A. Herbst, Jr, MD

Arch Surg. 1978;113(12):1421-1425.

Abstract
• A retrospective outcome-oriented audit was conducted to determine the complications associated with percutaneous infraclavicular subclavian catheters in a university hospital. The study is unique since patients having these catheters were not under the care of a select group of physicians and the patients were not restricted to a special nursing unit. One hundred and seventeen catheters were placed in 68 patients. Seventeen types of complications were audited. There were 13 complications (11%) identified as follows: pneumothorax, seven; subcutaneous emphysema, one; subclavian artery hematoma, one; pleural effusion, one; improper position, two; and sepsis, one. No mortality was associated with catheter placement. Pattern analysis suggested physician inexperience as an important cause of complications. The difficulties of establishing a retrospective audit based on documentation errors and omissions are discussed.

(Arch Surg 113:1421-1425, 1978)

Author Affiliations
From the Department of Surgery, University of North Carolina School of Medicine, Chapel Hill.

Footnotes
Accepted for publication May 31, 1978.

Reprint requests to Department of Surgery, University of North Carolina School of Medicine, 136 Burnett-Womack Bldg 229-H, Chapel Hill, NC 27514 (Dr Herbst).

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