Standards of Care, and Strategies in the Prevention of Infection: A Primer on Central Venous Catheters (Part 2 of a 3-Part Series)

The use of vascular access devices is an inherent component of health care today. The varied situations calling for these devices include: the administration of antibiotics, fluids, pain medications, blood and blood products, and parenteral nutrition; hemodynamic monitoring; and blood sampling. Although these devices are common in the health care environment, they are not without risks. The most common life-threatening complication associated with central venous catheters is infection. Catheter-related bloodstream infection (CRBSI) is caused by colonization of the catheter, contamination of the catheter hub or infusate, and/or contamination of the catheter from the skin of the patient or health care worker. The health care worker, such as the vascular access nurse, can affect CRBSI rates by implementing the most current technologies; maintaining current knowledge related to intravenous therapy; implementing, and maintaining aseptic technique; and incorporating the standards, guidelines, and preventive strategies associated with vascular access nursing. This article provides an overview of central venous catheters (CVCs), the issue of CRBSI and CVCs, practice and technologies developed to prevent or decrease infections, current standards and guidelines, and preventive strategies.