 |
About Central Vascular Access Devices
|
Central vascular access devices, or central venous access devices (CVADs), are fundamental in the nursing care of the critically ill, those with chronic conditions (oncological needs, renal failure), and emergency care. CVADs include central venous catheters, implanted ports, hemodialysis catheters, umbilical catheters, central apheresis catheters, and peripherally inserted central catheters (PICC). CVADs provide numerous advantages over peripheral intravenous (IV) access, but the increased risk of infection, thrombosis and catheter malfunction require specialized care and precautions.
Nurses must institute preventive measures against CVAD complications, be vigilant and stay alert to signs and symptoms of complications when caring for patients with CVADs and be prepared to intervene when complications are suspected. Avoiding complications begins with proper device selection and placement. The Infusion Nurses Society (INS) 2021 infusion standards of practice recommend the use of the smallest device, with the fewest lumens, and the least invasive device type required, to be maintained for the shortest duration possible (Gorski et al., 2021). The provider, nurse and patient will decide together which type of CVAD best meets the treatment needs while considering lifestyle factors. The use of standard precautions, aseptic technique, maintaining a sterile dressing, complying with institution-specific site care, and adhering to proper cleaning of needleless connectors and flushing protocols applies to all vascular access devices.