Optimizing Vascular Access Device Removal: Evidence-Based Strategies and Recommendations

Within vascular access, the removal of devices plays a critical role in patient care, necessitating adherence to evidence-based protocols to mitigate risks and ensure optimal outcomes. Drawing upon reputable guidelines and research findings, let’s explore the best practices and recommendations for removing various vascular access devices.

Peripheral Intravenous Catheters (PIVCs) and Midline Catheters:

  • The INS 9th Edition 2024 guidelines underscore the importance of assessing the necessity of PIVCs and midline catheters regularly.
  • Removal criteria include discontinuation from the treatment plan, unused status for 24 hours or more, and consideration of systemic complications.
  • Swift removal of catheters inserted under suboptimal aseptic conditions is recommended to prevent infections and complications.

Nontunneled Central Vascular Access Devices (CVADs) and PICCs:

  • Daily assessment of the continued need for nontunneled CVADs and PICCs is advised, aligning with best practices outlined in the INS guidelines.
  • Collaborative decision-making with the healthcare team is crucial for timely removal when devices are no longer essential for treatment.
  • Precautions, such as preventing air embolism and avoiding forceful removal, are essential to minimize complications during CVAD removal.

Surgically Placed CVADs - Tunneled, Cuffed Catheters, and Implanted Ports:

  • Regular evaluation of tunneled cuffed catheters and implanted ports is recommended to ensure appropriateness and functionality.
  • Removal protocols should be initiated upon completion of infusion therapy or when devices are no longer integral to the care plan.
  • Immediate reporting and management of any complications, such as cuff or port exposure, are imperative to prevent adverse events.

These evidence-based strategies emphasize the significance of systematic assessment, collaborative decision-making, and adherence to established guidelines to optimize vascular access device removal and enhance patient safety.

For a deeper dive into the research underpinning these recommendations, refer to the INS 9th Edition 2024 guidelines and explore scholarly resources from the AAP and Cochrane Library. By integrating research-driven practices into clinical workflows, healthcare providers can elevate the standard of care in vascular access management.