Procedures nurses use to remove central venous catheters and complications they observe: a pilot study

Removal of internal jugular and subclavian central venous catheters is a common nursing intervention. Venous air embolism is a serious complication of catheter removal. Although some procedures have been recommended to prevent venous air embolism, whether nurses use these procedures and what complications patients experience are unknown.

The purposes of this pilot study were (1) to determine what procedures nurses use to remove internal jugular and subclavian central venous catheters, (2) to find out what complications patients are experiencing, (3) to find out if complications experienced are related to the procedures used, and (4) to develop a questionnaire about central venous catheters.

A descriptive and correlational design was used. The subjects were 29 nurses whose job description included removal of internal jugular and subclavian central venous catheters. Two questionnaires were used: a demographics questionnaire and the questionnaire about central venous catheters.

Descriptive statistics were used to analyze the sample, to determine the percentage of nurses sampled who use the recommended procedures, and to describe the frequency of complications observed. The sample size was not sufficient for observed complications to be correlated with procedures.

None of the nurses sampled had venous air embolism diagnosed in their patients. They reported observing dyspnea, pain, bleeding from the insertion site, and arrhythmias. Many of the nurses reported that they did not always use all the recommended procedures; only 9 nurses (31%) reported always using all the recommended procedures.