JVAThe Journal ofVascular AccessReviewThe Journal of Vascular AccessRegistered Nurses'Association of1-14The Author(s)2023Artice reuse guidelinesOntario (RNAO)best practicesagepub.com/journals-pemmissionsD0L10.11771I297298231169468guideline on the assessment andjoumals.sagepub.com/home/jvaSAGEmanagement of vascular access devicesChristine Buchanan'D,Amy Burt,Nancy Moureau2D,Darlene Murray3Dand Nafsin Nizum'AbstractIntroduction:Vascular access is the most common invasive procedure performed in health care.This fundamentalprocedure must be performed in a safe and effective manner.Vascular access devices(VADs)are often the source ofinfections and other complications,yet there is a lack of clear guidance on VADs for health providers across differentsettings.A Best Practice Guideline (BPG)was developed by the Registered Nurses'Association of Ontario(RNAO)toprovide evidence-based recommendations on the assessment and management of VADs.Methods:RNAO BPGs are based on systematic reviews of the literature following the GRADE approach.Expertson the topic of vascular access were selected to form a panel.Systematic reviews were conducted on six researchareas:education,vascular access specialists,blood draws,daily review of peripheral VADs,visualization technologies,and pain management.A search for relevant research studies published in English limited to January 2013 was appliedto eight databases.All studies were independently assessed for eligibility and risk of bias by two reviewers based onpredetermined inclusion and exclusion criteria.The GRADE approach was used to determine certainty of the evidence.Results:Over 65,000 articles were screened related to the six priority research questions.Of these,876 full-textpublications were examined for relevance,with 174 articles designated to inform nine recommendations in the BPG onthe subject areas of:comprehensive health teaching,practical education for health providers,blood draws,daily reviewof peripheral VADs,visualization technologies,and pain management.In June 2021,the RNAO published the BPG onvascular access,which included the recommendations and other supporting resources.Conclusion:The vascular access BPG provides high quality guidance and updated recommendations,and can serve asa primary resource for health providers assessing and managing VADs.KeywordsGuideline,vascular access,nursing,systematic reviewDate received:16 September 2022;accepted:20January 2023Introductiontoward the heart.Reliable vascular access is fundamentalfor safe and effective care.2Complications associated withA variety of vascular access devices (VADs)are used inhealth care,including:peripheral vascular access devices(PVADs),central vascular access devices (CVADs),Registered Nurses'Association of Ontario,Toronto,ON,CanadaPICC Excellence,Hartwell,GA,USA;Griffith University,Brisbane,QLDperipheral arterial catheters (PACs),and phlebotomyThe Hospital for Sick Children,Toronto,ON,Canadadevices.Peripheral catheters remain in the periphery
