Nursing and midwifery practice for maintenance of vascular access device patency. A cross-sectional survey

Abstract

Flushing practices for vascular access device flushing appear to vary widely. Specific areas of practice that warrant further investigation include questions about the efficacy of heparin for central device flushing, increasing adherence to the recommended 10mL diameter syringe use, increased use of prefilled flush syringes, identifying and standardising optimal volumes and frequency of flushing, and improving documentation of flush orders and administration.

Road map for improvement: Point prevalence audit and survey of central venous access devices in paediatric acute care

“…Another variable and inconsistent practice was the prescription of flushing solutions. While there is little evidence to identify the optimal flushing interventions for CVADs, flushes are generally believed to maintain catheter patency by preventing internal luminal occlusion and biofilm formation . Within this audit over half of CVADs had no flushes ordered at all, with variation in prescribed normal or heparinised saline for the remainder.…”

“…generally believed to maintain catheter patency by preventing internal luminal occlusion and biofilm formation. 34,35 Within this audit over half of CVADs had no flushes ordered at all, with variation in prescribed normal or heparinised saline for the remainder. This variation is likely to be a reflection of the poor level of evidence to support clinical decision-making.…”

Flushing of peripheral intravenous catheters: A pilot, factorial, randomised controlled trial of high versus low frequency and volume in paediatrics

“…This could be remedied by sufficient funding to support timely screening, recruitment, data collection and follow‐up for a larger trial. We recommend adopting the following strategies in future studies: Tailoring research question to clinical setting and population. Modifying intervention arms to suit the clinical setting and population. Increased funding for study to optimise screening and recruitment. Engaging local staff from study inception to proactively notify potential study recruits Providing more education to parents and children to optimise participation. …”

“…Current practice at the study site was PIVC flushing every 6 h with variable volume based on clinician prescription. Intervention definitions were based on the findings of a large survey of practice and literature . The flushing solution used was isotonic 0.9% sodium chloride, manually prepared and administered by nursing staff.…”

Taxa De Incidência E O Uso Do Flushing Na Prevenção Das Obstruções De Cateter Venoso Periférico

“…This practice was also documented in another study. 24 The intermittent usage of the flushing technique seems to increase the PVC staying in its place, when compared to the lack of flushing 12 and has showed similar results when compared to the solutions containing anticoagulants (heparin). [12][13]17 Although the flushing technique is part of our nursing practices, no uniformity regarding the volume and moment could be verified, once the nurses used normal saline solutions of 3 ml, 5 ml and 10 ml at the PVC and in most situations before administering the medications in order to evaluate the catheter permeability, and in others circumstances before and after administering the medications.…”