Authors: Emily K. Jarding, Major, USAF, NC, MS, AGCNS-BC, MHAMary Beth Flynn Makic, PhD, RN, CCNS, FAAN, FNAP, FCNS
Central line–associated bloodstream infections occur not only in the intensive care unit but also the non–intensive care units of the hospital. The purpose of this article is to review current evidence to guide perianesthesia nurses in the care of a patient with a central vascular access device (CVAD). The CVAD bundle focuses on five key elements: hand hygiene, maximal sterile barrier, chlorhexidine antiseptic, catheter site selection, and daily evaluation of the need for the device. Once the CVAD is placed, evidence-based care and maintenance are the responsibility of the nurse. Ensuring proper maintenance and care of a CVAD falls within nursing practice and interventions can significantly reduce the patient's risk of central line–associated bloodstream infection. The single most crucial step a nurse can take to help prevent central line–associated bloodstream infections is performing proper hand hygiene. Other interventions focus on dressing management, bathing practices, access of intravenous infusion sets, blood draws, and management of port line occlusions. Familiarity and adoption of best practice interventions in the maintenance and care of patients with CVADs will help the perianesthesia nurse protect patients and prevent harm.