Central Lines: Current Standards of Practice
Central venous access devices (CVADs) provide reliable vascular access for patients requiring complex, prolonged, or specialized infusion therapy. Because these devices terminate within the central circulation, their use allows administration of therapies that may be inappropriate for peripheral veins and can provide dependable access for medications, fluids, blood products, parenteral nutrition, blood sampling, and other clinical needs. However, central vascular access also carries significant risks, including infection, thrombosis, occlusion, catheter malposition or migration, extravasation, air embolism, and other potentially serious complications.
This comprehensive course provides nurses and other qualified healthcare professionals with current, evidence-based guidance for the selection, assessment, care, maintenance, and discontinuation of central venous access devices. Content addresses non-tunneled central venous catheters, peripherally inserted central catheters (PICCs), tunneled catheters, and implanted vascular access ports, with emphasis on selecting the most appropriate device for the prescribed therapy and individual patient.
Learners will review central venous anatomy and catheter tip location, device selection and insertion considerations, infection-prevention practices, catheter stabilization and dressing care, needleless connectors, flushing and locking, administration set management, blood sampling, and implanted port access. Special attention is given to preventing central line-associated bloodstream infection (CLABSI), maintaining catheter patency, recognizing complications early, and responding appropriately when catheter dysfunction or complications occur.
The course concludes with evidence-based principles for CVAD removal, ongoing assessment and documentation, patient and caregiver education, and skills competency checklists that may be used in accordance with organizational policy and applicable scope-of-practice requirements.
Important: Completion of this educational course does not independently establish clinical competency or authorize performance of central venous access procedures. Clinicians must practice within applicable laws and regulations, professional scope of practice, organizational policy, and demonstrated competency requirements.
Questions? Check out our FAQs page and How Online IV Certification Works!
This comprehensive course provides nurses and other qualified healthcare professionals with current, evidence-based guidance for the selection, assessment, care, maintenance, and discontinuation of central venous access devices. Content addresses non-tunneled central venous catheters, peripherally inserted central catheters (PICCs), tunneled catheters, and implanted vascular access ports, with emphasis on selecting the most appropriate device for the prescribed therapy and individual patient.
Learners will review central venous anatomy and catheter tip location, device selection and insertion considerations, infection-prevention practices, catheter stabilization and dressing care, needleless connectors, flushing and locking, administration set management, blood sampling, and implanted port access. Special attention is given to preventing central line-associated bloodstream infection (CLABSI), maintaining catheter patency, recognizing complications early, and responding appropriately when catheter dysfunction or complications occur.
The course concludes with evidence-based principles for CVAD removal, ongoing assessment and documentation, patient and caregiver education, and skills competency checklists that may be used in accordance with organizational policy and applicable scope-of-practice requirements.
Important: Completion of this educational course does not independently establish clinical competency or authorize performance of central venous access procedures. Clinicians must practice within applicable laws and regulations, professional scope of practice, organizational policy, and demonstrated competency requirements.
Questions? Check out our FAQs page and How Online IV Certification Works!
Objectives
Upon completion of this course, the participant will be able to:
- Differentiate the major types of central venous access devices (CVADs) and identify appropriate indications, characteristics, advantages, and limitations of each.
- Identify appropriate central venous access sites and catheter tip locations and describe key considerations for CVAD selection and placement.
- Apply evidence-based practices for the assessment, care, and maintenance of CVADs, including infection prevention, dressing and site care, needleless connector management, flushing, locking, and maintaining catheter patency.
- Apply safe practices for accessing and using CVADs, including medication and infusion administration, blood specimen collection, and implanted port access and de-access.
- Recognize common CVAD complications and identify appropriate interventions for infectious, thrombotic, mechanical, infusion-related, and insertion-related complications.
- Describe appropriate practices for CVAD discontinuation, documentation, and patient/caregiver education throughout the course of central venous access therapy.
Curriculum
Chapter 1: Central Venous Access Device Fundamentals
- Definition and characteristics of a central venous access device
- Indications and clinical uses for central vascular access
- Benefits, limitations, and risks of CVADs
- Single- and multi-lumen catheter configurations
- Open-ended and valved catheter designs
- Non-tunneled central venous catheters
- Peripherally inserted central catheters (PICCs)
- Tunneled central venous catheters
- Implanted vascular access ports
- Power-injectable devices and device identification
- Veins used for central vascular access
- Upper-extremity anatomy relevant to PICC placement
- Internal jugular, subclavian, and femoral access
- Central venous circulation and the cavoatrial junction
- Recommended catheter tip position
- Methods of tip-location confirmation
- Recognition and implications of catheter malposition
- Vascular access and therapy assessment
- Infusate characteristics and anticipated duration of therapy
- Patient-specific risk factors and contraindications
- Vessel preservation and special populations
- Device and lumen selection
- Ultrasound assessment and catheter-to-vein considerations
- Patient preparation and informed consent
- Infection-prevention practices and maximal sterile barrier precautions
- Patient education before and after insertion
- Routine assessment of the CVAD and infusion system
- Hand hygiene and aseptic access
- Needleless connectors and hub disinfection
- Catheter stabilization and securement
- Site protection and bathing considerations
- Dressing assessment and dressing changes
- Skin antisepsis and chlorhexidine-containing dressings
- Flushing, locking, and patency assessment
- Administration set and add-on device management
- Blood sampling from a CVAD
- Implanted port access, maintenance, and de-access
- Patient safety during ongoing CVAD use
- Catheter dysfunction and loss of blood return
- Catheter migration and malposition
- Infiltration and extravasation from a CVAD
- Local infection and bloodstream infection
- CLABSI/CRBSI prevention and recognition
- Air embolism
- Catheter-related cardiac complications
- Pneumothorax, hemothorax, and other insertion-related complications
- Pinch-off syndrome
- Medical adhesive-related skin injury (MARSI)
- Nerve injury and other less-common complications
- Indications for CVAD removal
- Determining who may remove specific device types
- Preparation for catheter removal
- Safe removal of PICCs and eligible non-tunneled CVADs
- Prevention and recognition of air embolism
- Management of resistance during catheter removal
- Catheter integrity assessment after removal
- Hemostasis and post-removal site care
- Post-removal monitoring
- Removal-related documentation and patient education
- Ongoing necessity assessment
- Routine CVAD and infusion-system assessment
- Documentation of device insertion and tip confirmation
- Documentation of maintenance and infusion therapy
- Documentation of complications and interventions
- Documentation of CVAD removal
- Patient and caregiver education
- Home and outpatient CVAD safety
- Signs and symptoms requiring immediate reporting
- Transitions of care and communication
- CVAD assessment
- Central line dressing change
- Needleless connector change
- CVAD flushing and locking
- Blood specimen collection from a CVAD
- Implanted port access
- Implanted port de-access
- Medication administration through a CVAD
- Removal of a PICC or non-tunneled CVAD
Price: $60.00
Contact Hours: 5
Course Author
Capra Garrison
Capra Garrison, Registered Nurse, has more than 33 years of experience in infusion therapy and the instruction of licensed nurses in infusion therapy continuing education. Her experience comes from multiple infusion settings: acute care, ambulatory infusion centers, home infusion, long term care continuing education provider, and long term care pharmacy quality assurance consultant. Capra has an avid interest in holistic healing, nutrition, herbs, and alternative therapies for the treatment of disease in humans as well as animals.
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Course Accreditation
See our Accreditation Statements page to view our accreditation information.