School Nurses on the Front Lines of Healthcare: Children With Medical Devices—Central Venous Access Device Malfunctions and Infections

An important subgroup of children with special healthcare needs are children with medical complexities that require long-term intensive healthcare interventions and treatments. As medical technology continues to advance and children with complex medical needs survive the neonatal period and progress into school-age, it is essential for school nurses to be able to recognize and acutely manage complications and malfunctions of devices in children requiring assistance from medical devices. An example of a common medical device includes central venous access devices that allow for access to the bloodstream to obtain blood for laboratory testing or to infuse medications or nutrition. These devices put children at serious medical or surgical risk when they malfunction or become infected, so it is important for healthcare providers, especially school nurses who are the first responders in schools, to recognize malfunctions and initiate appropriate care management.