A central venous catheter (CVC) is a long, soft plastic tube that is placed into a large vein leading to the heart to allow intravenous (IV) fluids and medications to be given over an extended period of time. CVCs can also be used to obtain blood samples for tests that may be challenging to obtain otherwise.
A CVC can remain in place for weeks to months. There are different types of CVCs; the type required for each patient depends on the illness and therapy required.
Risks Associated with CVCs
While CVCs provide numerous benefits to patients, there are risks associated with their use. Complications associated with CVCs can be both hazardous and expensive.
CVCs are associated with certain complications including air emboli, central line-associated blood stream infections (CLABSI), blood clots and mechanical complications during the insertion process such as accidental placement in an artery instead of a vein, or a punctured lung.
In order to prevent these complications, BWH has under taken several improvement initiatives in both the training of providers and care of patients with CVCs.
Managing Risks Associated with CVCs
BWH has created and implemented a comprehensive protocol for CVC placement, which includes:
CVC insertion training and supervision for physicians
Checklist use for physicians and nurses
Use of ultrasound during CVC placement procedures
High-risk patient protocol
Standardized CVC insertion kits
Improved documentation through computer order entry templates
In conjunction with recommendations from Infection Control, new processes for cleansing the catheter site and protocols for dressing changes have also been implemented.