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Two audit tools were developed by the working party by adapting the fishbone diagram and the New South Wales policy directive for "central venous access device insertion and post insertion care" (NSW Health PD 2011-060) to ensure each element of CVDC care was properly reviewed.
Forty episodes of clinical practice of CVDC care were observed and recorded on the clinical observation audit tool.
Fifty-five patients with a CVDC had their medical record charts audited.
* Standardised practice for accessing CVDC to ensure evidence-based practice and to minimise practice variation.
The patient continued haemodialysis as an outpatient via a CVDC whilst awaiting wound healing and resolution of swelling.
No longer is a long term CVDC seen as the only option.
A thirty day prospective audit on CVDC exit site care with dressing changes and the application of Mupirocin[TM] ointment was carried out.
A questionnaire was developed as the audit tool for the CVDC audit (Table 1).
For the CVDC exit site dressing changes, the audit showed that out of the 18 randomly selected patients with the vascular catheter, 50% of the patients had documentation indicating full adherence (4 times + if required) with dressing changes (Graph 1).
Results from the pilot study were presented to the participating units who considered the instrument was measuring clinically significant areas in relation to CVDC nursing care.
Following the pilot study the questionnaire was designed to address several aspects relating to CVDC care.
Information relating to CVDC insertion characteristics were sought.
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