Reducing Central Venous Access Device (CVAD) Complications in Acute Care Paediatrics

Abstract

Objective Central venous access devices (CVADs) are an integral component of modern paediatric healthcare; however, the insertion and use of these devices are associated with serious complications. CVAD management strategies, including their dressing and securement, have been developed to reduce CVAD-associated complications. Nurses are key managers in promoting paediatric CVAD function, through the consistent use of effective management strategies. The aims of this PhD study were to: (1) identify current clinical management for CVADs within Australian paediatric facilities; (2) evaluate the feasibility of launching a full-scale efficacy trial of tunnelled cuffed CVAD securement and dressing products within acute care paediatrics; and (3) provide baseline estimates of the effectiveness of four dressings and securement products on tunnelled cuffed CVAD complication and failure, within a pilot study. Design A two-phased study was undertaken: a point prevalence audit and cross-sectional survey of paediatric CVAD management practices; and a four-armed, pilot randomised controlled trial (RCT) of innovative tunnelled, cuffed CVAD dressing and securement products to prevent complication and failure within paediatric acute care.