Evidence-based Practice: Improving Outcomes for Patients with a Central Venous Access Device

Abstract

PurposeTo apply evidence-based practice when flushing central venous access devices (CVADs). Background/IntroductionThere is a lack of standardized flushing protocols for CVADs among health care institutions. Identifying best practice and assuring skillful implementation of evidence-based practice protocols is essential to maintaining catheter patency. Review of Relevant LiteratureEvidence supports the use of nonheparinized saline flush, positive-pressure valve caps, and proper flushing technique to maintain CVAD patency (Bowers, Speroni, Jones, & Atherton, 2008; Hadaway, 2006; &Jasinsky & Wurster, 2009). Reinforcement of proper flushing techniques has demonstrated improved patency rates of CVADs (Feehery, Allen, & Bey, 2003). MethodsCorporate and individual in-services were conducted to improve nurses’ skill and knowledge of evidencebased practice related to flushing CVADs. Outcomes were measured by comparing baseline data with data collected in the same manner post-education. Data was obtained by means of a questionnaire and direct observation of nurses’ flushing technique. OutcomesThe evidence-based practice project demonstrated a significant improvement (p <0.05) in both the nurses’ knowledge and skill in flushing CVADs. ConclusionContinuing education and reinforcement of proper flushing technique is an appropriate strategy to increase knowledge of and compliance with evidence-based practice protocols. Implications for practiceProviding continuing education and periodic reinforcement of nursing skills can lead to improved patient outcomes. These strategies, along with changing flushing protocols to non-heparinized saline, can also reduce health care costs. Future studies are needed to determine the appropriate frequency of in-service education.