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At our last Program Educators meeting I was tasked with the job of finding out what other areas are doing in regards to clamping vs not clamping of CVADs once they have been flushed and locked.

In our facility, Brandon Regional Health Center (BRHC), we do not have positive pressure caps, but we use a positive pressure flushing technique in which the line is clamped at the end of flushing and locking with a positive pressure established.

Our current practice is to leave the line clamped in hopes of maintaining the positive pressure and preventing catheter occlusions. The argument has been made that if we release the clamp we will release the positive pressure, cause negative pressure and cause blood to enter the tip of the catheter.

We seem to be noticing a higher incidence of catheter occlusions and Cathflo use and we are investigating what the cause may be. We realize that it may be technique of the positive pressure flushing and we are trying to refresh the training with staff to ensure they are aware of the proper technique.

Our question is whether our policy is consistent with other current recommendations. Should we clamp the line after flushing and locking and leave it clamped or should we open the clamp?

Thanks for any comments.