Central venous access devices: current technologies, uses, and management strategies.

The use of central venous catheters (CVCs) for vascular access is now commonplace in a variety of care settings. Technological advances related to CVCs have introduced a multitude of catheter designs that are available to us through numerous manufacturers. To initiate the appropriate procedures for care, nurses involved in the maintenance of central venous access devices are now challenged with having to be familiar with a large variety of central venous access devices. They must be able to evaluate a CVC and determine its type, size, manufacturer, and specific characteristics as well as to initiate the appropriate management strategies related to that device. The nurse must also be able to recognize the indications, advantages and disadvantages associated with each device, and to assist the patient in making an informed decision regarding the appropriate device for his or her therapy needs. It is essential that care and maintenance procedures be delivered by those whose knowledge base and experience make them competent care providers with the expertise to initiate appropriate prevention and troubleshooting measures, as well as to evaluate and implement nursing actions related to complications.