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Vascular Access Device SUMMARY
Updated 04/03

The new VAD Policy has been approved!!
This new document has several changes that will further assist the clinician in preventing catheter-related blood stream infections.

Introduction

This policy is intended for any adult patient with a venous access device (VAD) including a peripheral line, single lumen, multi-lumen, tunneled, Total Parenteral Nutrition (TPN) lines, implantable ports, peripherally inserted central catheter (PICC), Hohn, dialysis, or hemapharesis catheters. The procedures detailed in this policy include the standard requirements for training, VAD site selection, insertion, site assessment, dressing change requirements, documentation requirements, appropriate flushing procedures, tubing replacement and line removal and/or replacement requirements.

A brief summary of the major changes is provided below. Please download the full policy for more specific information or detail.

Training:

  • All individuals who insert, care or manipulate VADs are required to undergo appropriate training module prior to use of the devices.

Insertion:

  • All central VAD are to be inserted using maximal sterile barriers.
  • All VAD placed under emergent situations will be removed as soon as medically feasible.
  • Chlorehexidine gluconate 2% in 70% isopropyl alcohol (Chloroprep) is the antiseptic of choice for insertion.

Site Assessment:

  • Clinical grading criteria for the documentation of phlebitis have been added.

Dressing Change:

  • Dressing will be changed every 7 days unless they become loose, damp or soiled.
  • Chlorehexidine gluconate 2% in 70% isopropyl alcohol (Chloroprep) is the antiseptic of choice for site care.
  • A dressing change of a central VADs is a sterile procedure.

Tubing:

  • All administration sets other than those used for TPN or blood infusion, will be changed and labeled every 96 hours.
  • Blood administration sets will be changes every 24 hours.
  • If VAD tubing becomes disconnected, the connecting port will be cleaned with a 70% isopropyl alcohol swab and new tubing attached at the clave connection.

Blood Draws and Flushes:

  • See complete policy for detailed instruction of flushing and heparin locking procedures.

Removal and Replacement:

  • Central VADs will not be routinely replaced, but the need for access will be reviewed daily and the catheter removed as soon as central access is no longer needed.

Education:

  • Physicians, nurse practitioners, physician assistants and specially trained registered nurses who insert lines must complete the VAD training module available at www.hopkins-heic.org prior to line insertion.
  • Registered Nurses and technicians who care for VADs must complete a nursing education module available through that office.

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