Preventing air embolism when removing CVCs: an evidence-based approach to changing practice.

Evidence-based medicine has been defined as "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients" (Sackett et al., 1996). Evidence-based nursing takes the process one step further by integrating clinical expertise and the data obtained from performance improvement processes with clinical research. The challenge nursing then faces is to translate the evidence into practice. Although central line removal is a fairly common procedure, it is not benign. The authors noted an opportunity for improving central venous catheter (CVC) removal from the subclavian or internal jugular vein. Based upon previously recommended guidelines (Kim et al., 1998), the authors set out to determine the best practice related to CVC removal.