Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Practice Recommendations


Practice Recommendation Level of Evidence
1. Assessment and Device Selection
All clients requiring vascular access, regardless of duration of therapy, require the use of a structured approach such as an algorithm to facilitate a comprehensive client assessment and the development of a vascular access care plan prior to the initiation of therapy.

2. Factors to Consider
To determine the most appropriate type of vascular access device, the nurse needs to consider the following factors:

  • Prescribed therapy
  • Duration of therapy
  • Physical assessment
  • Client health history
  • Support system/resources
  • Device availability
  • Client preference
Level Ib
Level Ib
Level IV
Level IV
Level IV
Level IV
Level IV
3. Client Education
Nurses will discuss the options for vascular access devices with the client and family caregivers. Device selection is a collaborative process between the nurse, client, physician and other members of the health care team. However, the nurse has a role to educate and advocate for clients in relation to the selection of appropriate devices.

4. Documentation

  • Nurses will document comprehensive information regarding assessment of infusion therapy and device recommendations. This documentation should include, as a minimum:
  • Assessment completed and the written plan of care developed; and Client and family caregiver education.