For Physicians

Insertion of Central Venous Catheters 3.0


Description
This course is primarily intended for health care providers who insert central venous catheters (CVCs). There is a separate course available from Duke Infection Control Outreach Network (DICON) for nurses who are involved in the care and maintenance of CVCs.

The course consists of text, slides and video clips, post-test and evaluation form. The course has been updated to include MANDATORY and OPTIONAL sections. You will only have to complete the mandatory sections prior to taking the quiz to receive CE credits. The course will take approximately 2 hours to complete.

Continuing Education (CE) credit is available on completion of the Mandatory section of the course. Release Date: 7/28/2017; Review Date: 7/08/2020; End Date: 7/08/2022; Estimated time to complete – 2.0 hrs.

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 2.0 AMA PRA Category 1 Credit(s)TM. Physicians should claim only credit commensurate with the extent of their participation in the activity.

Nurse CE: Duke University Health System Department of Clinical Education and Professional Development designates this activity for up to 2 credit hour for nurses. Nurses should claim only credit commensurate with the extent of their participation in this activity

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. Selection of Patient, Catheter Site and Type
  • I.1 Selection of Patient, Catheter Site and Type - Background
  • I.2 Indications for CVC Insertion
  • I.3 Selecting the type of CVC
  • I.4 Selection of Central Venous Access
  • II. Preparation for Placement
  • II.1 Placement of CVCs-General Principles
  • II.2 Proper Timing Of Catheterization
  • II.3 Assemble required equipment
  • II.4 Informed Consent
  • II.5 Prepare the Patient
  • II.6 Prepare the Patient Room
  • II.7 Perform “Time out” procedure to verify the identity of the patient
  • II.8 The CVC bundle
  • II.9 CVC bundle item #1: Hand Hygiene and Personal Protection Equipment
  • II.10 CVC bundle item #2: Chlorhexidine Skin Antisepsis
  • II.11 CVC bundle item #3: Maximal Barrier Protection
  • II.12 CVC bundle item #4: Select the appropriate site for catheter insertion
  • II.13 CVC bundle item #5: Assess indication for CVC
  • II.14 Complete a safety checklist
  • II.15 Using Ultrasound Guidance
  • III. Peripherally Inserted Central Catheter
  • III.1 Peripherally Inserted Central Catheter - Overview
  • III.2 Introduction
  • III.3 Anatomy of the Superficial Antecubital Fossa
  • III.4 Type of Catheter
  • III.5 Preparation
  • III.6 Insertion Technique
  • III.7 Confirmation of Catheter Tip Location
  • IV. Infraclavicular Subclavian Vein CVC
  • IV.1 Infraclavicular Subclavian Vein CVC - Anatomy
  • IV.2 Patient Preparation: Positioning
  • IV.3 Patient Preparation: Positioning of the Head
  • IV.4 Proper Skin Preparation
  • IV.5 Insertion Technique
  • IV.6 Insertion Technique: Insertion of needle
  • IV.7 Insertion Technique: Guidewire
  • IV.8 Insertion Technique: Testing for catheter location
  • IV.9 Securing the Catheter
  • IV.10 Insertion Technique: Following placement
  • IV.11 Documenting Catheter Position
  • IV.12 Special Considerations in Placing a Subclavian Catheter
  • V. Internal Jugular Vein CVC
  • V.1 Internal Jugular Vein CVC - Anatomy
  • V.2 Positioning for Percutaneous Insertion
  • V.3 Insertion Techniques
  • V.4 Internal Jugular CVC
  • VI. Ultrasound-guided CVC placement
  • VI.1 Ultrasound-guided CVC placement - Introduction
  • VI.2 Maintain Aseptic Technique
  • VI.3 Technique for Insertion
  • VI.4 Technique for Insertion - Transverse View
  • VI.5 Technique for Insertion - Longitudinal View
  • VI.6 Technique for Insertion - Seldinger Technique
  • VI.7 Technical Considerations
  • VII. Indications for Removal
  • VII.1 Clinical Indications to Consider Removal of Catheter
  • VII.2 Removal of Temporary Central Access Catheters
  • Assesment
  • Post Test: Insertion of Central Venous Catheters 3
  • Course Survey: Insertion of Central Venous Catheters
  • Optional Sections
  • Overview of Optional Sections
  • VIII. Guidelines for Care and Maintenance of the CVC
  • VIII.1 Guidelines for Care and Maintenance of the CVC - Introduction
  • VIII.2 How often should IV tubing be changed?
  • VIII.3 What is the recommended technique for changing IVs attached to the CVC?
  • VIII.4 Dressing changes to the CVC site
  • VIII.5 Method for changing CVC dressing
  • VIII.6 Frequency of changing CVC dressing
  • VIII.7 Daily inspection of CVC dressings
  • IX. Infectious Complications
  • IX.1 Infectious Complications - Introduction
  • IX.2 Exit Site Infection
  • IX.3 Catheter Tract Infection (Tunnel Infection)
  • IX.4 Catheter-Related Sepsis
  • IX.5 Evaluation of True or Suspected Sepsis (Fever)
  • IX.6 Recommended Clinical Practice
  • IX.7 Conclusion
  • IX.8 Osteomyelitis of Clavicle Due to Subclavian Catheter
  • IX.9 Osteomyelitis of Clavicle Due to Subclavian Catheter
  • X. Mechanical Complications
  • X.1 Mechanical Complications - Introduction
  • X.2 Improper Catheter Tip Location
  • X.3 Repositioning the catheter tip
  • X.4 Pneumothorax
  • X.5 Arterial Puncture
  • X.6 Re-establish patency
  • X.7 Positional Obstruction of Subclavian Catheters
  • X.8 Management of Obstructed Catheters
  • X.9 Clogging: Failure to Aspirate Blood
  • X.10 “Testing” the catheter
  • X.11 Thrombosis
  • X.12 Treatment of thrombosis
  • X.13 Prevention of Thrombosis
  • X.14 Leaking from the Exit Site
  • X.15 Air Embolism
  • X.16 Symptoms of Air Embolism
  • X.17 Treatment of Air Embolism
  • XI. Other Complications
  • XI.1 Other Complications - Catheter Embolism
  • XI.2 Other Complications - Chylothorax
  • XI.3 Neurological Complications
  • XI.4 Complications Central Vein Catheterization
  • References for Insertion of Central Venous Catheters
Completion rules
  • You must complete the units "Post Test: Insertion of Central Venous Catheters 3, Course Survey: Insertion of Central Venous Catheters"
  • Leads to a certification with a duration: Forever