The Infusion Nurses Society (INS) defines vascular access devices (VADs) by their intended duration of use, anatomical placement, and design. Understanding the distinction between short-term and long-term devices is essential for proper clinical decision-making and patient care.
Short-Term Devices
- Intended Duration: Typically designed for use over a period of days to a few weeks.
- Common Types: Non-tunneled central venous catheters (CVCs), and peripheral intravenous catheters (PIVCs).
- Clinical Use: Used when intravenous therapy is expected to be brief, such as for acute illness, surgery, or short courses of antibiotics.
- Management: These devices are reviewed daily for necessity and are removed as soon as they are no longer required to reduce infection risk.
Long-Term Devices
- Intended Duration: Designed for use over months to years.
- Common Types: Tunneled central venous catheters, totally implantable venous access devices (ports), and long-term PICCs.
- Clinical Use: Indicated for patients requiring ongoing therapy, such as chemotherapy, long-term antibiotics, or parenteral nutrition.
- Management: These devices are engineered for extended dwell time and require specialized care to maintain patency and prevent complications.
INS Standards Emphasis
- The INS standards stress that device selection should be based on the anticipated duration of therapy and the patient’s clinical needs.
- Devices should not be removed solely based on dwell time but rather on clinical indications such as infection, device malfunction, or therapy completion.
- Proper documentation and identification of device types are crucial for safe patient care.
Short-term devices are intended for temporary access (days to weeks), while long-term devices are designed for ongoing therapy (months to years). The INS standards provide clear guidance to ensure appropriate device selection and management based on therapy duration and patient requirements.
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References:
Nickel, B. et al., (2024, January/ February) Infusion Therapy Standards of Practice 9th edition. Journal of Infusion Nursing. https://www.ins1.org/publications/infusion-therapy-standards-of-practice/