Access Device Guidelines and Recommendations for Practice (Second Edition)

Buy Book

Introduction

More than three decades ago, IV drugs only could be administered through short-term vascular access devices. Today, numerous short-term and long-term devices are available to access the venous, intraspinal, arterial, peritoneal, and intraventricular body systems. The increased variety of access devices has enabled healthcare professionals to develop complex treatment plans with the goal of increasing patient survival.

Constantly evolving technology leads to the frequent introduction of new access devices to the market and provides technological modifications to existing devices. Routine care and management of potential complications vary among the specific design or type of access device. Although the literature is replete with studies, controversies still exist concerning the optimal management procedures. However, it is clear that the patient’s quality of life has improved dramatically in the past three decades with the advances in access device technology. This edition of Access Device Guidelines: Recommendations for Nursing Practice and Education explores the latest technologies, management procedures, and other issues related to the use of access devices.

Several device maintenance methods are used, yet few randomized, controlled trials have been conducted and evaluated to guide nursing care. An extensive literature search on each access device has been undertaken for this publication. The guidelines developed from this synthesis of evidence focus on strict hand washing and consistent maintenance care with the use of aseptic technique. Ongoing monitoring for infection and occlusion rates will help any institution to evaluate their policies and to determine if changes or revisions need to be made.

The Oncology Nursing Society developed these guidelines to provide recommendations for application of access device technology within nursing practice. For the clinician, the guidelines will provide the basis for clinical policies and procedures in all patient-care settings. Nurse educators can use the guidelines in developing access device educational programs. The guidelines include detailed outlines for didactic and clinical practicum that can be used for competency-based evaluation. Nurse researchers will be challenged by the controversial issues associated with access devices.

Guidelines for the use of access devices are indispensable in the management of patients with cancer. Modern technology has enhanced the safety and efficacy of administration methods for cancer treatments and supportive-care agents. Nursing research is essential to establish scientifically based methods for access device care and the management of complications. Developing the expertise needed to manage access devices is a continual challenge to healthcare professionals. The intent of these guidelines is to provide the foundation for evidence-based practice that practitioners can use to guide their practice.