Abstract

Purpose: To apply evidence-based practice when flushing central venous access devices (CVADs).

Background/Introduction: There 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 Literature: Evidence 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).

Methods: Corporate and individual in-services were conducted to improve nurses' skill and knowledge of evidence-based 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.

Outcomes: The evidence-based practice project demonstrated a significant improvement (p <0.05) in both the nurses' knowledge and skill in flushing CVADs.

Conclusion: Continuing education and reinforcement of proper flushing technique is an appropriate strategy to increase knowledge of and compliance with evidence-based practice protocols.

Implications for practice: Providing 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.

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