Impact of CVAD on Patient Condition: Infection, Management, and Prevention

This research essay discusses the impact of CVAD (Central Venous Access Device) on the condition of the patient, including the occurrence and management of infections caused by CVAD. Strategies for preventing infection and managing occlusion are also explored.

Nursing

Table of Contents
INTRODUCTION...........................................................................................................................3
ESSAY.............................................................................................................................................3
CONCLUSION................................................................................................................................5
REFERENCES................................................................................................................................6

INTRODUCTION
Nursing is a profession in which a patient is cared so it can maintain, attain, the quality of
medical aid. This is about providing proper aid to the patient with feeling and intensity. This
research essay is about CVAD(Central Venous access device) that how its use will impact on the
condition of patient. The solution to the infection cause by CVAD is also discussed. Apart from
that, its reason of occurrence and management is also discussed.
ESSAY
According to Amanda. (2015), CVAD is the device that is inserted into the body veins so
that the administration of the blood products, medication and fluids can be managed. It is
inserted into the body veins which can be subclavian or jugular vein. Apart from that it can also
be inserted into the peripheral veins of upper extremities. Since CVAD is generally a safe
procurement but sometimes its use can cause a serious infection. On the other hand Tourangeau
and et. al., (2016), there are a number of strategies which can be used to protect the infection
caused by it such as antimicrobial, impregnated lines which is used for the prevention of
infection. Apart from that, a valve can also be used to prevent occlusion by preventing reuse of
blood in catheter. When catheter is used with saline or heparin it can also prevent in the
formation of blood clotting and occlusion of the blood catheters.
According to the Alligood, (2017) CVAD is used by health care professionals on the
basis of necessity of device i.e. short, long, or medium term, requirement of treatment, used
frequency and availability of vein. On the other side Shin, Park and Kim, (2015) Normally, the
short term use of non-tunnelled and umbilical CVADs are for 7-8 days, PICC(Peripherally
inserted central catheters) are used for short to medium term i.e. for 4 weeks to 6 months. While
tunnelled CVAD and implantable catheters are used for long term use i.e. for years. In case of
Joseph, since it has not regained its consciousness therefore CVAD is used for it. When Joseph
regained its consciousness, it has responded to the person standing in front of it and it was
weaned from the ventilator.
As per the point of view of Bernal and et. al., (2015) There are two types of infections
Joseph can face with the use of CVAD such as local site infection and blood stream infection.
When CVAD is transferred to the site of Joseph than the chances of skin organism at the
insertion site, contamination of internal device hub etc. When bacteria enters the site of CVAD

than there is a chance of increase local infection at that site. On the other hand Betihavas and et.
al., (2016), the failure of CVAD is also resulted in the local infection. CVAD can also break at
the time of insertion inside body therefore it should be implanted well in a patient. When CVAD
is fail it results in the device failure which is caused by fibrin sheath. It causes malfunction when
the sheath extends over the CVAD. Therefore the use of it should be proper enough so that
Joseph can survive more efficiently.
According to the Cañadas-De la Fuente and et. al., (2015) the strategies to prevent a
patient from the occlusion of CVAD should be performed at regular interval. Flushing of HCP
should be considered at regular interval so that use of CVAD can be denied at regular interval.
As CVAD is used regularly it will impact badly on the heath of patient. On the other hand
Hemphill 3rd and et. al., (2018), the NS solutions are implanted with flushing between the
administration of incompatible medication and prevention of CVAD occlusion with the help of
precipitation and crystallization. To maintain patency NS solutions are commonly used with
CVAD flushing. To the locking of fluid CVAD, NS flushing is also a common practice. To
maintain CVAD Catheter patency the concentration of heparin should be in its lowest level such
10 units/ml or 100 units/ml.
As per the point of view of Holloway and Galvin, (2016) there are many CVAD
occlusion causes which occurs. Some of them are Inability to withdraw blood or sluggish blood
return, Sluggish flow, Infiltration or swelling at the infusion site etc. In case of sluggish blood
return CVAD fails in which flow of blood is interrupted. On the other hand Masters, (2018),
since CVAD is used to flow the blood continuously in body but if flow of blood interrupted than
the occlusion of CVAD can be there. According to the Veenema, (2018), in case of Sluggish
flow the cause of occlusion of CVAD in which the flow of blood is sluggish which is not flowing
to its normal speed. With this problem a patient can face an issue of low blood pressure which
results into excessive pressure on heart. In the end, the reason of failure of CVAD in which
swelling occurs at the area where the infusion is started.
According to the Muller and Bester, (2016), there are three ways through which
Occlusion of CVAD can be managed. The ways include mechanical obstruction of catheter,
catheter obstruction related to medication or parenteral nutrition and thrombotic catheter
obstruction. On the other hand Potter and et. al., (2018) In the above management solutions, a

standard procedure should be followed to diagnose and manage CVC obstruction. If it is
observed that the solutions are proper than the occlusion of CVAD can be managed accordingly.
CONCLUSION
In this report it can be concluded that the use of CVAD should be proper so that the
Occlusion within it can be overcome. Although there are many solutions through which
occlusion can be overcome but instead that to use should be properly managed. There are many
solutions also by which an occlusion can be managed. The use of CVAD is to allow the flow of
blood into vessels freely which can be interrupted due to cholesterol or etc. If the occlusion
occurred in CVAD than the use of it will be wasted.

REFERENCES
Books and Journals
Alligood, M. R., 2017. Nursing Theorists and Their Work-E-Book. Elsevier Health Sciences.
Bernal and et. al., 2015. Work-related psychosocial risk factors and musculoskeletal disorders in
hospital nurses and nursing aides: a systematic review and meta-analysis. International
journal of nursing studies. 52(2). pp.635-648.
Betihavas and et. al., 2016. The evidence for ‘flipping out’: a systematic review of the flipped
classroom in nursing education. Nurse education today. 38. pp.15-21.
Cañadas-De la Fuente and et. al., 2015. Risk factors and prevalence of burnout syndrome in the
nursing profession. International journal of nursing studies. 52(1). pp.240-249.
Hemphill 3rd, J. C., S. M and et. al., 2018 "American Heart Association Stroke Council; Council
on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology. Guidelines for
the management of spontaneous intracerebral hemorrhage: a guideline for healthcare
professionals from the American Heart Association/American Stroke
Association." Stroke 46, no. 7 (2015): 2032-2060.
Holloway, I. and Galvin, K., 2016. Qualitative research in nursing and healthcare. John Wiley
& Sons.
Masters, K., 2018. Role Development Professional Nursing Practice. Jones & Bartlett Learning.
Muller, M. E. and Bester, P., 2016. Nursing dynamics. Pearson Southern Africa (Pty) Limited.
Potter and et. al., 2018. Canadian fundamentals of nursing. Elsevier Health Sciences.
Shin, S., Park, J. H. and Kim, J. H., 2015. Effectiveness of patient simulation in nursing
education: meta-analysis. Nurse education today. 35(1). pp.176-182.
Tourangeau and et. al., 2016. Nursing-related determinants of 30-day mortality for hospitalized
patients. Canadian Journal of Nursing Research Archive. 33(4).
Veenema, T. G. ed., 2018. Disaster nursing and emergency preparedness. Springer Publishing
Company.
Online
Amanda, 2015., Central Venous Access Devices. [Online]. Available
through:<http://pediatrics.aappublications.org/content/136/5/e1331>.