Abstract:
Invasive intravenous catheters, commonly known as central venous catheters (CVCs), infuse life-saving medications and products to patients but require maintenance flushing solutions to preserve their functionality. The most commonly used maintenance flushing solutions are heparin and normal saline, but there is limited evidence-based research supporting the superiority of one flushing solution for occlusion prevention (Goossens, 2015). The problem is with over 5 million CVCs inserted yearly in the U.S. up to 35% fail because of occlusions. The retrospective three-month chart review of adult intensive care patient’s electronic health records (EHRs), conducted at a Midwest medical center, explored the effectiveness of flushing 6 milliliters of heparin concentrated with 10 units per milliliter every eight hours on CVC occlusion rates over the indwelling duration of the CVC. Iowa’s Model of Evidence-Based Practice to Promote Quality Care theory aligned with the study findings for integration of policy change and development of CVC flushing standardization in clinical practice. A Kolmogorov-Smirnov test, found no significant difference (p < 0.05) in (N = 47) heparinized flushing and CVC occlusion rates using a 95% confidence interval. The study concluded heparin is an effective flushing solution in preventing CVC occlusions in adult ICU patients. Incidental findings include 5 EHRs lacking documentation for CVC removal. Future study recommendations include comparing the effectiveness of heparin to normal saline flushes on occlusion prevention in short and long-term CVC use, and developing a quality improvement project addressing CVC occlusion and removal rationale documentation.
