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Central venous access devices: review of practice
Linda Douglas1, Anne Aspin, Norma Jimmeson
1Hull Royal Infirmary, Hull and East Yorkshire NHS Trust.
Paediatric Nursing
|June 26, 2009
Summary
Central venous access device care varies widely among hospitals. This study surveyed practices, finding inconsistencies in dressings, cleansing agents, and flush solutions, highlighting the need for standardized guidelines.
Area of Science:
- Nursing Practice
- Medical Device Management
- Patient Safety
Background:
- Central venous access device (CVAD) management is a complex nursing task with potential for serious complications.
- Significant variations exist in CVAD care and maintenance protocols across and within healthcare facilities.
- Previous literature reviews and audits indicated a need to update practice guidelines.
Purpose of the Study:
- To inform the review and standardization of practice guidelines for central venous access device care.
- To identify current practices in tertiary pediatric surgical and neonatal units.
- To reduce variations in CVAD management and associated complications.
Main Methods:
- A postal survey was conducted targeting 22 national tertiary pediatric surgical centers and neonatal units.
- Questionnaires collected data on types of CVADs, dressings, cleansing agents, flush solutions, and syringe sizes.
- Data collection focused on practices relevant to CVAD maintenance and care.
Main Results:
- Broviac catheters were identified as the most commonly used central venous access devices.
- Considerable variation was observed in the types of dressings, cleansing agents, flush solutions, and syringe sizes employed.
- Practices differed significantly between and within the surveyed institutions.
Conclusions:
- Evidence from literature reviews, audits, and the survey supports recommendations for dressing types, cleansing agents, and syringe sizes.
- The selection of flush solutions and their volumes should align with manufacturer recommendations.
- Implementing standardized practice guidelines, supported by bedside instructions, can enhance CVAD care and patient safety.
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