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Efficacy of Reducing Alteplase Dose to Restore Patency in Nonhemodialysis Central Vascular Access Devices

Plohal, Ann PhD, APRN, ACNS-BC, CRNI®; Schiller, Krishna PharmD

doi: 10.1097/NAN.0000000000000209
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Central line-associated bloodstream infections (CLABSIs) are preventable through vigilant and thorough care.1 When CLABSIs occurred at a facility in Southwest Arizona, the root cause analysis discovered that declotting agents, such as alteplase, were not given routinely when nonhemodialysis (non-HD) central vascular access devices (CVADs) lacked blood return. A PICO question was developed that guided the review of literature and central line care standards of practice: In the adult patients with non-HD central lines, what medications are currently recommended to restore patency? As a result of this project, our facility instituted a new protocol using a reduced dose of alteplase to restore patency to non-HD CVADs.

Dignity Health–St. Joseph's Hospital and Medical Center, Phoenix, Arizona (Dr Plohal) and Banner University Medical Center–Phoenix, Phoenix, Arizona (Dr Schiller).

Ann Plohal, PhD, APRN, ACNS-BC, CRNI®, works at Dignity Health–St. Joseph's Hospital and Medical Center, Phoenix, Arizona.

Krishna Schiller, PharmD, works at Banner University Medical Center–Phoenix, Phoenix, Arizona.

Corresponding Author: Ann Plohal, PhD, APRN, ACNS-BC, CRNI® (annplohal@gmail.com).

The authors have no conflicts of interest to disclose.

© Copyright 2017 by Infusion Nurses Society