Central venous access devices: review of practice

Management of central venous access devices is a complex nursing activity with the potential for serious complications. There are variations in the care and maintenance of these devices, between and within, hospitals. Building on previous literature reviews and audits, a postal survey was undertaken to inform review of practice guidelines.

Questionnaires were sent to 22 national, tertiary paediatric surgical centres and neonatal units where neonatal surgery was undertaken. Respondents were asked to provide information on: types of access devices and dressings used, cleansing agents, solutions to flush the device and sizes of syringes used to access the device.

Broviac catheters were the most common. There was considerable variation in practice with a range of dressings, cleansing agents, flush solutions and syringe sizes.

Literature reviews, practice audits and the postal survey provide good evidenc for recommendations on dressing type, cleansing agent and syringe size. Selection of flush solution and amount to be used depend on manufacturer advice. Implementation of these practice guidelines can be supported by placing printed instructions at the bedside of each patient with a central venous access device.