Assessment of Duration of Vascular Access Device Use in Patients with Cancer

Background, Rationale and Suggested Implementation Strategies

Create or share educational materials regarding the appropriateness of dwell time for various vascular access devices.
Educating staff about the appropriate indications for each type of catheter supports evidence-based practice and enhances the quality of care delivered.
Create and/or use guidelines based on evidence that outline the scenarios in which different types of devices would be appropriate based on length of treatment, ensuring alignment with national safety standards.
Engage with key stakeholders, including nurses, physicians, and administrators, to secure buy-in and support for optimizing dwell type by device type, highlighting the benefits for patient safety and cost savings.

References

General Hematology/Oncology

Moss, J et al. Central Venous Access Devices for the Delivery of Systemic Anticancer Therapy (CAVA): A Randomised Controlled Trial. Lancet 2021.
- Open-label, multi-center randomized controlled trial of 1,061 adult patients receiving systemic anticancer treatment (SACT) for solid or hematological malignancy via PICCs vs Hickman vs Ports. The median dwell time of ports (over 350 days) was much greater than Hickman (around 160 days) and PICCs (around 120 days).
Skummer, P. et al. Risk Factors for Early Port Infections in Adult Oncologic Patients. J Vasc Interv Radiol 2020.
- Retrospective study of 1,714 patients who underwent port placements. A total of 20 patients (1.2%) had early port infections; 15 patients (0.9%) had positive blood cultures. The mean time to infection was 20 days (range, 9-30 days). The port-related 30-day mortality rate was 0.2% (4 of 1,714 patients).

HMS Active Malignancy Vascular Access Toolkit