CVAD Care & Teaching Consistency PDF

# CVAD Care ## The Importance of Teaching "Consistency" - Patients, caregivers, and clinicians often voice concerns and frustrations about different approaches, and lack of a standard approach to teaching topics and content. - Clinicians may minimize what another has taught, stating they are mor...

# CVAD Care ## The Importance of Teaching "Consistency" - Patients, caregivers, and clinicians often voice concerns and frustrations about different approaches, and lack of a standard approach to teaching topics and content. - Clinicians may minimize what another has taught, stating they are more experienced and more knowledgeable, or the clinician in the hospital provides different information than the home care clinician without explanation. - Evidence of conflict between clinicians and lack of consistency has a negative impact on understanding, acceptance, and possibly adherence to aspects of CVAD care. - As patients move across different acute care units and across the continuum of care, we must do better. - Checklists providing key topics to be addressed as part of CVAD education should be available and can also serve as a documentation tool (refer to CVAD Care and Management Teaching Topics chart below). - Without a checklist, it is easy to miss necessary topics relative to CVAD teaching. - However, a checklist is not a substitute for clinician competence. Clinicians who provide CVAD teaching must be educated and competent in CVAD care and management as well as teaching strategies. ### CVAD Care and Management Teaching Topics - Activity limitations imposed by CVAD - protection during bathing - securing external catheter tubing to prevent accidental dislodgement - Safe/appropriate location for CVAD related supplies/biohazard container - Checking CVAD site daily and reporting any unusual signs/symptoms (fever, redness, swelling, pain/soreness, drainage, dressing dislodgement) - Hand hygiene before and after all CVAD care (including clinicians) - Concept of aseptic technique (e.g., Aseptic Non-Touch Technique (2018)- no touching of syringe tip, disinfected needleless connector, IV administration set spike/male luer end) - Preparing flush syringes - Disinfection of needleless connector/correct use of disinfection caps if used - CVAD flushing and locking technique - CVAD site care and dressing change procedure, if appropriate ## Evaluation of Teaching - Learning is consistently evaluated through teach-back and return demonstration processes. - Consider multiple teaching methods for the patient, caregiver or family member that is exhibiting difficulty or inability to learn CVAD care procedures, particularly in the home setting without ready access to health care providers. - Some questions for the clinician to consider include the following: - Has healthcare literacy been assessed? - Have effective teaching strategies been consistently implemented? - Is there consistency in instructions? Have multiple clinicians provided teaching? Are they consistent in approach? Could the patient benefit from more consistency of assessment with a fewer number of clinicians involved? - What are the specific issues affecting the learning process? For example, anxiety, functional/cognitive limitations, motivation, or distractions in the home? - Are additional home visits likely to result in a positive outcome? - For patients or caregivers expected to learn an infusion procedure and care for the CVAD, is another infusion setting (i.e., outpatient) more appropriate for care? Perhaps the patient and caregivers are competent with protecting the CVAD during activities of daily living and identifying potential problems but cannot safely flush/lock the CVAD and administer infusions due to functional and cognitive limitations." ## Summary - Clinicians across all health care settings who provide CVAD related patient education must be well-educated and competent in vascular access procedures and care and management - Clinicians must also be able to effectively educate patients and families - Patient education, increasing their knowledge, skills, and abilities, is an important aspect of engaging the patient in healthcare. - Patient education involves providing information about CVAD and optimally, whenever possible shared decision making before CVAD placement. - Patient education is much more than just providing information. - It requires assessment of issues that impact the teaching-learning process such as readiness to learn, culture, language preferences, and health literacy. - It requires implementation of effective teaching strategies including attention to plain language both in oral and written communication and consistent use of the teach-back approach.