Catheter management.

OBJECTIVES: To review the care and maintenance of the central venous access device (VAD), including dressing management, practice of accessing, swabbing, deaccessing and flushing, specific IV connectors, and practice considerations when sampling blood and VAD removal.

DATA SOURCES: Journal articles, compendiums and standards, case reports, manufacturers' product information, personal experience.

CONCLUSION: The available data on VAD care and maintenance depends on data from a variety of sources. VAD care is product-dependent and, while some basic actions are universal to dressing management, septum swabbing, and catheter flushing, it is important to understand the idiosyncrasies of various products to provide the best and safest care.

IMPLICATIONS FOR NURSING PRACTICE: Critical thinking skills and individualized care planning are necessary for the care and maintenance of VADs, which is a primary role of the nurse.