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

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Abstract

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.

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