This best practice guideline focuses on assisting all nurses in diverse practice settings, both institutional and community, who provide care to clients requiring vascular access. This guideline incorporates best practices related to the care and maintenance of vascular access devices applicable to all adult clients requiring this kind of care. It should be noted that the main focus of this guideline is the care and maintenance of central venous access devices (CVAD); however, where care and maintenance strategies can be used for both CVAD and peripheral venous access devices (PVAD), this has been articulated in the specific recommendations. This guideline does not include recommendations related to the care of clients requiring infusion therapy through the following devices: arterial lines, hemodialysis catheters, pulmonary artery lines, pheresis lines, epidural catheters, pressure monitoring devices, umbilical vein, femoral catheters, and/or intraosseous lines. Nurses working with other types of vascular access devices will require further practice direction from guidelines in their unique area of practice.
The purpose of this guideline is to provide evidence-based support for nurses related to the care and maintenance of vascular access devices, client education and safety. Specific clinical questions to be addressed include:
- How can the risk of complications be minimized through appropriate care and maintenance of vascular access devices?
- What strategies should be used for client and staff education to address the care and maintenance of vascular access devices?
It is acknowledged that the individual competencies of nurses varies between nurses and across categories of nursing professionals (RPNs and RNs) and are based on knowledge, skills, attitudes, critical analysis and decision making which are enhanced over time by experience and education. It is expected that individual nurses will perform only those aspects of care and maintenance for vascular access devices for which they have received appropriate education and have experience. It is expected that nurses will seek appropriate consultation in instances where the client’s care needs surpass the nurse’s ability to act independently. It is acknowledged that effective healthcare depends on a coordinated health care team approach incorporating ongoing communication between health professionals and clients, ever mindful of the personal choices and unique needs of each individual client.
As of September, 7, 2015, the Multiple IV Infusion Safety e-learning modules will no longer be hosted by the Registered Nurses' Association of Ontario. For access to the e-learning modules and related materials after this date, please contact the e-learning developers directly at firstname.lastname@example.org