Vascular Access Devices
is typically changed weekly. Filters and administration sets should be changed every 24 hours (or every 12 hours for lipids hanging separately).1
Patient Education
To avoid serious complications, patients receiving HPN must be taught proper procedures for maintaining a VAD to ensure it is clean and work- ing well. Patients must also be educated on how to recognize key signs and symptoms that may signal infection, occlusion, or other complica- tions that may require admission to the hospital for treatment. A thor- ough teaching on VAD care and maintenance, with written educational materials provided in the patient’s preferred language, is highly recom- mended prior to the patient leaving the hospital or health care facility. Refer to Figure 6.1 in Chapter 6 for a sample checklist of items that should be included in patient education for HPN.
References
1. Nickel B, Gorski L, Kleidon T, et al. Infusion therapy standards of practice, 9th edition. J Infus Nurs. 2024;47(1S suppl 1):S1-S285. doi:10 . 1097 / NAN . 0000000000000532
2. Boullata JI, Gilbert K, Sacks G, et al. A.S.P.E.N. clinical guidelines: parenteral nutrition ordering, order review, compounding, labeling, and dispensing. JPEN J Parenter Enteral Nutr. 2014;38(3):334-377. doi:10 . 1177 / 0148607114521833
3. Gabriel J. Long-term central venous access device selection. Nurs Times. 2013;109(39):12-15.
4. Sands MJ. Vascular access in the adult home infusion patient. JPEN J Parenter Enteral Nutr. 2006;30(1 suppl):S57-S64. doi:10 . 1177 / 01486071060300S1S57
5. Tushar K. Parenteral access devices. In: Chan L-N, ed. ASPEN Adult Nutrition Support Core Curriculum. 4th ed. American Society for Parenteral and Enteral Nutrition; 2025:435-465.
6. O’Grady NP, Alexander M, Burns LA, et al. Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention. 2011. Accessed February 1, 2025. www. cdc . gov /infection-control/media/pdfs/Guideline-BSI-H.pdf
7. American Society of Anesthesiologists. Practice guidelines for central venous access 2020: an updated report by the American Society of Anesthesiologists Task Force on Central Venous Access. Anesthesiology. 2020;132(1):8-43. doi:10 . 1097 / ALN . 0000000000002864
8. Hamilton C, Seidner DL. Home parenteral nutrition. In: Ireton-Jones C, Delegge M, eds. Handbook of Home Nutrition Support. Jones and Bartlett; 2007:115-152.
9. Derenski K, Catlin J, Allen L. Parenteral nutrition basics for the clinician caring for the adult patient. Nutr Clin Pract. 2016;31(5):578-595. doi:10 . 1177 / 0884533616657650
10. Flick AI, Winters R. Vascular tunneled central catheter access. In: StatPearls. StatPearls Publishing. Updated July 4, 2023. Accessed February 1, 2025. www. ncbi . nlm . nih . gov / books / NBK557614
11. Steiger E; HPEN Working Group. Consensus statements regarding optimal management of home parenteral nutrition (HPN) access. JPEN J Parenter Enteral Nutr. 2006;30(1 suppl):S94-S95. doi:10 . 1177 / 01486071060300S1S94
12. McCallum L, Higgins D. Care of peripheral venous cannula sites. Nurs Times. 2012;108(34-35):12-15.
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