A physician in the ICU has a practice of changing central venous catheters every five days. Which statement provides the strongest reason for supporting the facility's policy against this practice?

• A. An analysis of patient feedback that shows discomfort during catheter replacement
• B. Evidence-based guidelines, such as the Centers for Disease Control and Prevention (CDC) Guidelines for the Prevention of Intravascular Catheter-Related Infections
• C. A cost-benefit analysis that indicates CVCs are a significant expense
• D. A corporate policy that states catheters must be changed in the operating room

Answer: (B)

Evidence-based practice is the foundation for preventing device-related infections. The strongest reason to oppose routine, fixed-interval changing of central venous catheters is that established guidelines synthesize large bodies of evidence and expert consensus to show that replacing catheters on a calendar schedule does not reduce infection and can actually increase risk from repeated insertions and manipulations, along with patient discomfort and procedural hazards. By following guidelines such as those from the CDC, the facility adopts a strategy of removing or replacing a catheter based on clinical indications (infection, malfunction, thrombosis, or other complications) and maintaining rigorous aseptic technique and site care during use. This approach minimizes unnecessary catheter manipulations, lowers infection risk, and aligns practice with the best available evidence, rather than relying on cost or convenience alone. The other reasons—patient discomfort, cost-only analyses, or a policy mandating OR-based changes—do not address the infection prevention data as directly or provide as strong a justification as adhering to evidence-based guidelines.