Prevention and Treatment of CVAD Associated Bloodstream Infection and Occlusion

Running head: EVIDENCE BASED NURSING RESEARCH
EVIDENCE BASED NURSING RESEARCH
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1EVIDENCE BASED NURSING RESEARCH
Introduction:
The central venous access device or CVAD plays an important role in the recovery of
critical patient in the health care settings. However, study has indicated that high risk of
bloodstream infection and occlusion is associated with CVAD (Ullman et al. 2015). The purpose
of the essay is to provide brief discussion about the prevention of CVAD associated bloodstream
infection and occlusion. In this regards the following paper will provide the plan of care for
prevention of bloodstream infection and both the prevention and treatment of occlusion.
Association of CVAD with blood stream infection:
Central venous access device is a small, flexible tube that is placed in the large veins for
some patients that require access to the bloodstream frequently. The CVAD is mainly placed in
the large vein of neck or chest and in some cases in the groin as well (Moureau et al. 2013). As
found in the case of Joseph, CVAD plays an important role in nursing care. There are many
benefits of using CVAD, for example, it helps to administer drugs, medication and other
intravenous fluids and nutritional components, helps to transfuse different blood products and
helps to draw blood for diagnosis. In addition, the risk of blood clot, inflammation and scaring
due to the use of needles and anxiety is less in CVAD. Thus, in order to manage critical patients
in ICU most of the health professional prefer to use CVAD (Madenci et al. 2014).
Beside such advantages of using CVAD, several studies have identified the risk of
bloodstream infection due to the use of CVAD. A central line infection of bloodstream is most
common in ICU. Such infection leads to the increase morbidity, health care cost and death as
well. Due to such reason, CVAD associated bloodstream infection has become one of the major
concern for health care system (Chopra et al. 2013). However, it is important to use CVAD in

2EVIDENCE BASED NURSING RESEARCH
order to manage critical patients. Thus, some prevention measures have been introduced in order
to reduce the risk of infection and use the CVAD in an effective manner.
The insertion site of the CVAD is mostly related to the bloodstream infection. Thus, it is
important to insert the catheter properly. In order to reduce the risk of infection it is important to
select proper type of catheter and insert it according to the purpose and duration. Using midline
catheter instead of short line catheter could reduce the risk of infection (Deshmukh and Shinde
2014). In case of central venous catheter it is required to avoid the insertion through femoral
vein. Using an ultrasound guidance during the placement of CAVD could help to reduce the
mechanical complications and the number of attempts of cannulation, thus could reduce the risk
of infection effectively (Palomar et al. 2013). Maintaining hand hygiene and adequate aseptic
techniques before and after the insertion of CVAD is important to reduce the risk of infection. In
order to ensure safety cleaning of the skin with alcoholic chlorhexidine solution is required. It
would help to clean the germs in the skin and facilitate the insertion process (Gahlot et al. 2014).
Risk of infection increases with the duration of using CVAD, thus it is important to monitor the
CVAD in a daily basis in order to prevent the infection. Study has identified that the most
common source of bloodstream infection is the hubs of the CVAD. It serves as the pathway of
entry for microorganisms. Such microorganisms may be dispersed into the bloodstream through
the hubs and lumen and could cause severe infection. Thus, it is important to disinfect the surface
of the hubs before accessing those (Shah et al. 2013). It is important to change the administration
sets timely, because prolong use of one administration set could lead to the consequence of
infection. Finally, after removal of the CVAD proper dressing is important in order to prevent
infection (Deshmukh and Shinde 2014). Such process would help to reduce the risk of infection
and foster the recovery.