access device patency through flushing (Infusion Nurses Society, 2011; Royal Nurses’ Association of Ontario, 2005). Levels of evidence informing these recommendations were limited to level IV or V (i.e. single quasi-experimen- tal clinical/lab study or clinical opinion). Recommenda- tions about frequency, volume, syringe size or mode differed. Local guidelines are found to be similarly lacking or inconsistent.
The results of research comparing continuous infusion versus intermittent flushes to maintain catheter patency remain inconclusive, with studies yielding varied findings (Fernandez et al., 2003; Flint et al., 2005). There are no large multi site trials comparing different flushing regimens (i.e. regular versus PRN; 6 hourly versus daily; 3mL versus 10mL). Evidence about the use of heparinised flushing solution versus normal saline or other interventions is also inconclusive (Randolph et al., 1998). Indeed, the optimum approach to flushing practice is not known, therefore the inconsistent nature of flushing recommendations in orga- nisational guidelines is not surprising. Consequently, it is timely to survey current flushing practice related to maintenance of peripheral and central venous catheter patency.