Speaker
Description
Background:
Safe and competent management of central venous access devices (CVADs) is essential to preventing complications such as central line–associated bloodstream infections. An environmental scan within the Pediatric Intensive Care Unit (PICU) at CHEO identified gaps in standardized education, hands-on practice, and formal competency validation for CVAD care, revealing misalignment with the RNAO Vascular Access Best Practice Guideline (BPG), which emphasizes standardized, practical, and competency-based education. (RNAO, 2021)
Purpose:
This project aimed to develop, pilot, and evaluate a standardized CVAD Competency Development Guide to support consistent, evidence-based education and ongoing competence in CVAD care for frontline nursing staff, in alignment with the RNAO Vascular Access BPG.
Implementation Approach:
A structured, five-step CVAD Competency Development Guide (didactic learning, independent learning, practical education, skills validation, and competency maintenance) was developed using evidence-informed frameworks and key contributor's input (Giacomino et al., 2020; Kjelland, 2021). The guide was piloted with PICU preceptors, mentors, and newly hired nurses. Feedback was collected through surveys. To enhance practical education, a rapid-cycle deliberate practice simulation was developed and evaluated using pre- and post-simulation surveys (Ng et al., 2021; Suttle et al., 2025).
Results:
All pilot participants (n=13) reported increased confidence after using the guide, with 54% reporting a significant increase. 77% indicated that the structured, stepwise format strongly supported learning or teaching, and all participants found the guide relevant to clinical practice. Simulation participants (n=6) reported a 26.6% increase in confidence performing CVAD skills and a 19.9% improvement in understanding CLABSI prevention. All participants strongly agreed that real-time feedback and deliberate practice enhanced both skill acquisition and confidence.
Implications for Practice:
Standardized, structured competency tools combined with simulation-based education enhance nurse confidence and readiness for practice. This approach supports BPG implementation and is scalable to other clinical areas, with potential to strengthen patient safety and quality outcomes.
What RNAO BPG or tool/toolkit is your abstract related to?
RNAO Vascular Access Best Practice Guideline (2021)
RNAO BPSO Implementation Toolkit
Author(s) Credentials and Title
Emilie Casey, RN, BScN (Clinical Resource Nurse, Pediatric Intensive Care; Best Practice Champion Clinical Lead for 2025-2026).
| Organization Name | Children’s Hospital of Eastern Ontario (CHEO) |
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