Evidence-based consensus on the insertion of central venous access devices: definition of minimal requirements for training

N. Moureau, M. Lamperti, L. J. Kelly, R. Dawson, M. Elbarbary, A. J. H. van Boxtel, M. Pittiruti

Research output: Contribution to journalArticle

91 Citations (Scopus)

Abstract

There is a lack of standard minimal requirements for the training of insertion techniques and maintenance of central venous access devices (CVADs). An international evidence-based consensus task force was established through the World Congress of Vascular Access (WoCoVA) to provide definitions and recommendations for training and insertion of CVADs. Medical literature published from February 1971 to April 2012 regarding ocentral vascular access', otraining', ocompetency', osimulation', and oultrasound' was reviewed on Pubmed, BioMed Central, ScienceDirect, and Scopus databases. The GRADE and the GRADE-RAND methods were utilized to develop recommendations. Out of 156 papers initially identified, 83 papers described training for central vascular access placement. Sixteen recommendations are proposed by this task force, each with an evidence level, degree of consensus, and recommendation grade. These recommendations suggest central venous access education include didactic or web-based teaching with insertion procedure, infection prevention, complications, care, and maintenance of devices, along with laboratory models and tools for simulation practice incorporating ultrasound. Clinical competence should be determined by observation during clinical practice using a global rating scale rather than by the number of procedures performed. Ensuring safe insertion and management of central venous devices requires standardized education, simulation practice, and supervised insertions.
Original languageEnglish
Pages (from-to)347-356
JournalBritish Journal of Anaesthesia
Volume110
Issue number3
DOIs
Publication statusPublished - Mar 2013

Keywords

  • catheter-related infections
  • prevention and control
  • catheterization
  • central venous access
  • central venous
  • standards
  • clinical competence
  • competency
  • complications
  • computer-assisted instruction
  • consensus
  • evidence-based medicine
  • education
  • GRADE
  • guideline
  • humans
  • infection
  • internship and residency
  • programme development
  • programme evaluation
  • RAND
  • supervision
  • simulation
  • subclavian vein
  • training
  • ultrasound guidance
  • ultrasonography
  • vascular access
  • vascular surgical procedures

Cite this

Moureau, N., Lamperti, M., Kelly, L. J., Dawson, R., Elbarbary, M., van Boxtel, A. J. H., & Pittiruti, M. (2013). Evidence-based consensus on the insertion of central venous access devices: definition of minimal requirements for training. British Journal of Anaesthesia, 110(3), 347-356. https://doi.org/10.1093/bja/aes499