Nursing management of external central venous catheters (CVCs).

One major nursing care management problem in patients requiring long term and/or multiple intravenous therapy is adequate and reliable venous access. Poor venous access can often be a source of agony for the patient as well as the nurse. A number of venous access catheters and ports have been developed to help alleviate this problem. Of these devices, the most widely used external central venous catheters include: the Davol (Hickman, Broviac, Leonard catheters, Arrow-Howes multi-lumen catheters, and the Groshong that requires no heparinization. The nurse needs to be knowledgeable and skilled in the care of these catheters, as well as the management and prevention of potential or actual complications. Equally important is the nurse's role in patient/family teaching and evaluation of expected outcomes.