Download You`re flushing, but are you checking for a positive blood return?

You’re flushing, but are you checking
for a positive blood return?
Always aspirate for a positive blood return prior
to administering medications and solutions1
“Vascular access devices [should be] flushed and aspirated for a blood return
prior to each infusion to assess catheter function and prevent complications.”1
—INS Infusion Therapy Standards of Practice, 2016,
page S77, standard 40.1
“Central vascular access devices (CVADs) [should be] regularly assessed for
patency and proper function as defined by the ability to flush the catheter
without resistance and the ability to yield a blood return.”1
—INS Infusion Therapy Standards of Practice, 2016,
page S104, standard 48.1
“During the initial flush, slowly aspirate the VAD for blood return that is the color
and consistency of whole blood, which is an important component of assessing
catheter function prior to administration of medications and solutions.”1
—INS Infusion Therapy Standards of Practice, 2016,
page S77, standard 40, practice criterion D1
Promptly addressing catheter occlusion
is a goal of catheter management2
“Catheter salvage is the preferred approach for managing thrombosed catheters
as it helps to ensure limited interruption of therapy, reduced risk of trauma to the
patient, decreased risk of complications, and decreased costs.”2
—Haire WD, Herbst SF.
J Vasc Access Dev. Summer 2000:1-82
Are you documenting patency?
Key societies recommend documenting catheter patency
“Documentation includes, but is not limited to: results
of CVAD functionality assessment including patency,
absence of signs and symptoms of complications, lack
of resistance when flushing, and presence of a blood
return upon aspiration.”1
—INS Infusion Therapy Standards of Practice, 2016,
page S29, standard 10, practice criterion A10
Nursing documentation should include presence of
blood return or other body fluid and the ability to flush.3
—Access Device Guidelines: Recommendations
for Nursing Practice and Education, 2011
Documentation should indicate whether patency was
confirmed prior to administration of medications and solutions
Patency is confirmed when the line:
Flushes easily, without resistance
Aspirates easily, with brisk, free-flowing blood return
References: 1. Infusion Nurses Society. Infusion therapy standards of practice. J Infus Nurs. 2016;39(suppl 1):S1-S159. 2. Haire WD, Herbst SF. J Vasc Access Dev. Summer
2000:1-8. 3. Camp-Sorrell D, ed. Access Device Guidelines: Recommendations for Nursing Practice and Education. 3rd ed. Pittsburgh, PA: Oncology Nursing Society; 2011.
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