…those vascular access devices? Of course… all nurses who care for vascular access devices (VAD) should, right?? …. but do they ” flush and lock” or ” flush” only thinking that flushing is enough to keep the VAD patent?
The 2011 Infusion Nursing standards of practice makes this distinction….
“Flushing” – the act of moving fluids, medications, blood, blood products, and nutrients out of a vascular access device into the blood stream, ensuring delivery of those components and verifying device patency.
“Locking” – the instillation of a solution into a vascular access device to maintain device patency.
Some key points to remember:
- As part of the assessment of the VAD function, flush prior to each infusion and after to clear the medication/fluid from the catheter lumen.
- Use preservative free 0.9% Sodium Chloride for flushing.
- When assessing for catheter function prior to use, aspirate for blood return.
- Lock the VAD after the completion of the final flush to decrease the risk of occlusion.
- Lock short PIVs with preservative free 0.9% Sodium Chloride in adults and children.
- For CVAD, INS recommends the use of heparin lock solution 10units/ml after each intermittent use. Ports – use heparin 100u/ml. Hemodialysis/Aphresis – use 1000units/ml.
- Volume depends on catheter type/size, age of patient, and type of infusion given. Minimum volume is twice the internal volume of catheter.
- The organization must have policies and procedures on flushing and locking VAD.
Reference: 2011 Infusion Nursing Standards of Practice. Click here to order a copy.