• J Pediatr Oncol Nurs · Jul 2014

    Review

    Central Venous Catheter Flushing Recommendations: A Systematic Evidence-Based Practice Review.

    • Margaret Anne Conway, Claire McCollom, and Cynthia Bannon.
    • Boston Children's Hospital, Boston, MA, USA margaret.brill-conway@childrens.harvard.edu.
    • J Pediatr Oncol Nurs. 2014 Jul 1; 31 (4): 185-190.

    BackgroundTreatment for many children with blood disorders or cancer includes the use of central venous catheters (CVCs). Few prospective studies have been conducted to address flushing guidelines in pediatric hematology oncology patients. Eighteen pediatric hematology oncology units were surveyed regarding current CVC flushing policies and procedures. Results reported extreme variations in CVC flush procedures, which instigated this systematic review.AimsThe purpose of this project was to critically review current literature and expert opinion regarding CVC flushing practice in the hopes of reporting standardized recommendations. Dissemination of consistent recommendations may reduce practice variability and complications associated with CVCs as well as increase patient and family confidence and competence in providing CVC care.MethodsLiterature searches used PubMed, Medline, CINAHL, National Guidelines Clearinghouse, and Cochrane Database of Systematic Reviews. Multiple reviewers evaluated results relevant to CVC flushing procedures. Studies excluded were those that included neonates, peripheral intravenous catheters, dialysis catheters, and valved catheters.ResultsEvaluation of 5 randomized controlled trials, 3 observational studies, 2 systematic reviews, 7 guidelines, and 1 literature review using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) and Appraisal of Guidelines for Research & Evaluation II (AGREE II) tools, an overall low level of evidence, and weak recommendation for practice was concluded.ConclusionWeak recommendation for daily flushing of noninfusing Broviac/Hickman catheters and accessed implanted ports may be made. There was not sufficient evidence for heparin volume or concentration recommendations. No recommendations can be reported for peripherally inserted central venous catheters. Further research is indicated for CVC flushing procedures in pediatric hematology oncology patients.© 2014 by Association of Pediatric Hematology/Oncology Nurses.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…