Central venous access devices: Retrospective study of the implementation of a nursing led vascular access team and evaluation of complication rates

Abstract

Introduction:

Physicians have historically performed insertions of Central Venous Access Devices (CVADs). The ability to successfully place CVADs has increased with the implementation of ultrasound techniques to include safer placement and lower complications. The implementation of nursing lead vascular access teams (VATs) has become popular in hospitals for securing and maintaining access. This study aims to review a nursing lead team placing CVADs in comparison to physicians.

Methods:

The study was a retrospective single center study. Utilizing the VAT nurse procedure logs from 01/01/2019 to 06/30/2021, evaluation using chart review was performed to assess for: performing team, location of access, and any complications during and after the placement of central access. The data was stored on REDCAP data analysis tool without any protected health identification. After all the data was collected, it was sent for statistical analysis.

Results:

In this study, the primary outcome was an evaluation for difference in immediate complications between the physician and VAT group in insertion of CVADs. Analysis of 395 procedures for complications, including both Femoral (82) and Jugular (313) CVADs were evaluated based on the inserting team, physician (131) and VAT staff (264). The procedures were compared for immediate and delayed complications.

Discussion:

The complication rates and success rates were similar in both groups. Despite the study lacking enough power to be statistically significant, the outcomes of this study are promising, introducing new pathways for vascular access to accommodate both non-critically and critically ill patients.