Peripherally inserted central venous catheters.

It has been estimated that 5 million central venous catheters are used in the United States each year. The medical market has been inundated with vascular access devices representing phenomenal advancement in catheter technology. These devices are not without serious risk, however, and they require constant vigilance and scrupulous care to prevent life-threatening complications. Nursing care and management of these devices are complex, and many controversial practice issues challenge nursing practitioners. The insertion of central venous catheters by registered nurses is a relatively new adventure in nursing practice, increasing our professional responsibility, accountability, and liability. Scientific principles and research must direct our practice and our decisions. The challenge is to seize this opportunity to develop a new concept in IV therapy based on nursing research.