For Physicians

Safe Practices for Central Venous Catheter (CVC) Insertion: Refresher Course


Description
This course is primarily intended as a refresher course for healthcare providers who insert central venous catheters (CVCs) and who have already completed the DICON Insertion of Central Venous Catheter course. This course consists of text, slides and video clips, post-test and evaluation form. The course will take approximately 1 hour to complete.
Release Date: 11/01/2015; Latest Review Date: 7/08/2020; End Date: 7/08/2022;

There is a separate course Care and Maintenance of Central Venous Catheters available from Duke Infection Control Outreach Network (DICON) for nurses who are involved in the care and maintenance of CVCs.

Rationale
Modern medicine has become progressively more complex. Examples of this complexity include the technical aspects of insertion, care and maintenance, and removal of central venous catheters. These catheters are frequently used to deliver an array of intravenous medicines and fluids. However such devices have risks. Use of short-term and long term vascular catheters is associated with important and serious risks of mechanical and infective complications. Catheter-related bloodstream infections (CR-BSIs) can cause substantial morbidity and mortality and many such infections are preventable if meticulous care is used during insertion and maintenance of these CVCs. Prevention of vascular catheter-associated adverse events has become a cornerstone of patient safety programs at most American hospitals.

Instructions for Completion
Complete all sections of the on-line course in sequence in order to successfully complete the course and receive credit for completion. Learners must demonstrate performance by achieving a minimum of 80% on the post-test. In addition, to be credited with completion, submit the evaluation form which follows the post-test. You may then print a certificate of completion for your records.

Statement of Joint Accreditation
In support of improving patient care, Duke University Health System Clinical Education & Professional Development is accredited by the American Nurses Credentialing Center (ANCC), the Accreditation Council for Pharmacy Education (ACPE), and the Accreditation Council for Continuing Medical Education (ACCME), to provide continuing education for the healthcare team.

Category 1: Duke University Health System Department of Clinical Education and Professional Development designates this online activity for a maximum of 1 AMA PRA Category 1 Credit(s)TM. Physicians should claim only credit commensurate with the extent of their participation in the activity.

Nurse CE credit is NOT provided for this course.

Presented By
This enduring material is presented by the Duke Infection Control Outreach Network (DICON).
Contact Information for Content and CE
Paul A. Thacker, II
Administrative Director
Duke Infection Control Outreach Network (DICON)
Box 102359 DUMC
Durham, NC 27710
phone: 919-684-4560
fax: 919-681-7494
paul.thacker@duke.edu
Content
  • Instructions and Objectives
  • I. The Basics: Understanding indications and Complications of CVCs
  • I.1 Understanding indications and Complications of CVCs - Scope of the problem
  • I.2 The CVC Bundle
  • I.3 Improving Patient Outcomes
  • I.4 CVCs 101
  • I.5 CVCs 101 (cont.)
  • I.6 CVCs 101 (cont.)
  • I.7 Indications for short-term CVC placement
  • I.8 Indications for long-term CVC placement
  • I.9 Site Selection for short-term CVCs
  • I.10 Site selection for short-term CVCs (cont.)
  • I.11 Pathogenesis
  • II. Procedure Overview: Reducing the Infection Risk
  • II.1 Step 1: Preparing for the procedure
  • II.2 Step 2: Hand hygiene
  • II.3 Step 3: Proper attire
  • II.4 Step 4: Skin antisepsis
  • II.5 Step 5: Full barrier precautions
  • II.6 Step 6: Catheter insertion
  • II.7 Step 6: Catheter insertion video
  • II.8 Step 7: Securing the catheter
  • II.9 Step 8: Catheter dressing
  • II.10 Step 9: Documentation
  • II.11 Step 10: Daily catheter inspection and review of CVC indications
  • III. Accessing and Removing Catheters
  • III.1 Accessing catheters
  • III.2 Technique for catheter removal
  • III.3 Technique for catheter removal: non-tunneled short-term CVC
  • III.4 Technique for catheter removal: PICC
  • IV. Wrap-Up
  • IV.1 Minimizing the risk
  • IV.2 Minimizing the risk (cont.)
  • Assesment
  • Test: Safe Practices for Central Venous Catheter (CVC) Insertion
  • Post-Course Survey: Safe Practices for Central Venous Catheter
  • References for Insertion of Central Venous Catheters
Completion rules
  • All units must be completed
  • Leads to a certification with a duration: Forever