This is a detailed lesson plan, including key points, for the central venous access device competency training.

1. Trainer Lesson Plan: CVAD Competency Training Page 1 of 1
What Key Points
Program Intro – 10 minutes Introduce yourselves as the trainers. If necessary, give a
little information about your history and experience in
working with VADs.
Ask learners to introduce themselves. Ask them to tell
you about their previous experience in working with
CVADs. Ask if they have any specific information that
they came to learn. Write their questions and concerns
on the white board. Point out the ones that will be
covered in the training. Tell learners how you will
address the other issues.
Ask learners to look at the program objectives with you
and go over them.
Call attention to the competencies in the program
materials. Tell learners that they will need to
successfully demonstrate the skills to be certified as
competent.
Show Deltec video: Before the video, tell participants the following:
“The Best Choice for You:
• It is easiest to first classify CVADs by whether they
Understanding CVADs”
are external catheters or are implanted ports. Most
video: 15 min.
implanted ports have the port located in the chest;
some are located in the arm, however.
discussion: 5 min.
• This video will show CVADs with implanted ports
in the chest and arm and external catheters that
protrude from the chest and arm. The video will not
show non-tunneled subclavian or jugular catheters.
It also will not show dialysis catheters.
• Besides the fact that the video illustrates four types
of CVAD placements, it also provides some good
talking points for patient education.
After the video, tell learners the following:
• Non-tunneled and jugular catheters are inserted via
percutaneous stick into the internal or external
Vascular Access Team 11/04

2. Trainer Lesson Plan: CVAD Competency Training Page 2 of 2
What Key Points
jugular vein. Non-tunneled subclavian catheters are
inserted via percutaneous stick into the subclavian
vein. Dialysis catheters may be tunneled or not.
Show Bard video: Queue up the video to where it shows how the
Groshong valve works. Let the video run through were
“Insertion Groshong® PICC”
it shows the difference between open-end and Groshong
video: 2 minutes
catheter tips.
discussion: 2 minutes
Tell learners that the video shows how the Groshong
valve works and compares it to an open-end catheter.
After the learners complete the exercises, go over the
correct answers. Try to identify and correct learner
misconceptions.
In-class exercise – 5 minutes Give each learner a copy of the VENOUS ACCESS
DEVICE ORDERS and a set of in-class exercises:
Self-grading and discussion –
10 minutes
• Peripherally Inserted Central Catheter
• Subclavian Hickman Catheter
• Tunneled Catheter
• Tunneled Dialysis Catheter
• Implanted Vascular Access Device
Instruct learners to do the exercises. They should be
guided by the VENOUS ACCESS DEVICE ORDERS –
just as they would in clinical practice.
Show Deltec video: Before the video: tell learners that the video will show
how to palpate, assess, access, and deaccess the
“Clinician Information for the
implanted port.
Care and Maintenance of PORT-
A-CATH® AND P.A.S. PORT®
Implantable Venous Access
After the video, stress that sterile technique must be
Systems”
used when accessing implanted ports. This necessitates
use of the Central Line Dressing Tray. Show the tray to
video: 15 min.
learners.
discussion: 2 min.
Show Deltec video: Before the video, tell learners that the video will show
them how the Gripper Plus safety needle works.
“Gripper Plus Safety Needle:
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3. Trainer Lesson Plan: CVAD Competency Training Page 3 of 3
What Key Points
Training Video”
After the video, tell learners the following:
video: 2 minutes
• The non-coring needle must be inserted at a right
discussion: 2 minutes
angle to the bottom of the implanted port. At times
the port may lie at a slight angle in the chest. Either
rotate the port so that the septum is parallel to the
skin, or angle the needle to accommodate the angled
port.
• If the port is upside-down under the skin, meaning
the bottom is closest to the skin, DO NOT attempt to
rotate it. Doing so can twist the catheter or break it.
Instead, notify the primary MD. You will not be
able to use the implanted port until it has been
surgically revised.
• If unsure about port placement, always call the
Vascular Access Team for help. They are the
experts and are here help.
• Show learners the different Gripper Plus non-coring
needles that are available for arm- and chest- placed
implanted ports. Listed below are all the Gripper
Plus Safety Needles that are available at FSH.
1.1mm (19G) X 32mm (1 ¼ in.) – MATCOM 130004*
1.1mm (19G) X 25mm (1 in.) – MATCOM 194630* (used most)
0.9mm (20G) X 25mm (1 in.) – MATCOM 150464
0.9mm (20G) X 16mm (5/8 in.) – MATCOM 193369
1.1mm (19G) X 19mm (3/4 in.) – MATCOM 194629* (for arm)
0.9mm (20G) X 19mm (3/4 in.) – MATCOM 168438
*Asterisk indicates minimum needles to have on hand.
Sterile Gloves Demonstration and return demonstration
10 minutes
Give everyone a pack of sterile gloves and have them
show you how they don the gloves.
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4. Trainer Lesson Plan: CVAD Competency Training Page 4 of 4
What Key Points
Sterile Technique Review Review these points:
• Nurse dons mask and sterile gloves for procedure.
• Patient wears mask if concern about respiratory
infection.
• The drape in the sterile dressing kit is permeable.
Do not allow it to get wet. (Do not squirt saline or
lay swab sticks on it.) If it gets wet, it is
contaminated and you need to set up another sterile
field.
• The outer inch margin of the sterile field drape is not
considered sterile.
• The pre-filled syringes are not sterile. (The solution
inside the syringes is sterile.) You will need to put
empty sterile syringes in your field and fill them.
• Tell learners that there are a few ways to hold the
non sterile NS vial without contaminating the sterile
field. Some nurses place a sterile 4X4 in the field
and use it to hold the vial with the sterile gloved
hand. Other nurses turn the vial on its side and hold
it in place with an elbow. Some nurses wait to put
on the second sterile glove. It is up to the learner to
decide what works best – but the sterile field must
not be compromised.
Competency review and Go over the required supplies. Review the two
demonstration – 20 minutes
competencies with learners.
Drawing Blood, Administering Fluid, and Flushing
External-Port Central Venous Access Devices (CVADs)
Jugular and Subclavian Catheters, Tunneled
Catheters, and Percutaneously Inserted Central
Catheters (PICCs), Dialysis Catheters
Accessing, Drawing Blood, Administering Fluid,
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5. Trainer Lesson Plan: CVAD Competency Training Page 5 of 5
What Key Points
Flushing, and Deaccessing
Implanted Central Venous Access Devices (CVADs)
Chest and Arm Placement
• Emphasize that after drawing blood all blood must
be cleared from the catheter for two reasons. Blood
in the catheter and/or cap is a great medium for
bacteria and remaining blood can clot in the catheter.
• Use intermittent flush technique and as much sterile
NS flush as necessary to clear the catheter lumens of
blood. If unable to clear the cap of blood, simply
prime and change it.
Learner practice – 15 minutes Instruct learners to use the competencies as a guide for
skill practice. Observe, guide practice, and be available
to answer questions.
Competency demonstration – 10 The competencies are divided into parts, designated in
minutes per person.
bold, with a YES or NO to the far right. For each part
that is completed successfully, simply circle YES. For
each part that is not completed successfully, circle NO.
Also, check the step/s that were not completed correctly.
At the end of the competency are a few questions for
you to ask the learner. Indicate on the competency if
they were correctly answered.
At the very end, certify whether the learner met the
criteria for the competency by checking MET or NOT
MET. If NOT MET, write your action plan in the space
below. It may be something as simple as, “attend the
next class and redo the competency.”
Total time: 105 minutes plus 10 minutes per person.
Vascular Access Team 11/04