Why not DRAUP? Barriers to Substituting Ultrasound for X-ray in Central Venous Catheter Confirmation
Monday, April 8, 2024
11:10am – 11:17am
Location: 412
Authors: Daniel Suarez, Washington University in St. Louis Vivian Pham, Washington University in Saint Louis Arthur Forbriger, Washington University in St. Louis Tiffany Rosenzweig, Washington University School of Medicine Enyo Ablordeppey, Washingtion University School of Medicine ,
The DRAUP program is an evidence-based deimplementation initiative designed to reduce the reliance on routine chest radiographs (CXR) for confirming central venous catheter (CVC) placement. Instead, it promotes the use of point-of-care ultrasound (POCUS) for CVC confirmation, with an initial focus on the right internal jugular vein. DRAUP achieved nearly 50% adoption during early implementation, highlighting the need to address systemic barriers to motivate this transition. We used retrospective chart review to identify adoption barriers, finding that 49% of eligible cases used POCUS for CVC confirmation as intended. Results indicate that most missed DRAUP implementation opportunities had no identifiable barriers, emphasizing the importance of addressing systemic obstacles for successful deimplementation. Future research will focus on understanding the barriers from the perspective of providers to reduce inertia.