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Almost all hospitalized patients, as well as many outpatients, require some form of intravenous (IV) catheter, these small plastic tubes are used for administering medications, fluids, nutrition, or blood transfusions, drawing blood samples, or performing dialysis for patients with kidney failure, IV lines are generally categorized into two types: peripheral and central.Implanted catheters, designed for long-term use, can be tunneled, with a cuff at the skin entry to form a fibrous barrier against pathogens, or they can be PORTs, which feature a subcutaneous reservoir accessed via needle puncture through the skin (Williams L,2005) CRT, This pertains to the formation of blood clots in the veins and vessel walls surrounding the catheter, due to puncture or mechanical injury to the vessel's inner lining or as a result of the patient's underlying medical condition with the rapid advancement of intravenous infusion technology, central venous catheterization has emerged as an essential component of modern medical practice (Citla Sridhar D, 2020).A peripherally inserted central catheter (PICC) is another central catheter commonly used in hospitals, inserted into a small vein in the upper arm and ending in the superior vena cava, where the veins from the neck and arm converge with the heart (Evan N, 2018)

Central venous access devices (CVADs) can be classified based on factors such as duration of use, tip location, number of lumens, or insertion site Culverwell (E, 2022).As primary healthcare providers offering direct patient care and spending significant time with individuals, nurses hold a pivotal position in effectively identifying, preventing, and managing VTE in clinical settings (Yan T. 2020).Multiple factors could contribute to the observed increase, such as population aging, shifts in lifestyle, heightened awareness, and improved detection methods.CRT risk factors can be grouped into those associated with the catheter, the insertion procedure, and patient-related factors, reflecting Virchow's triad of endothelial injury, blood flow stasis, and hypercoagulability (Saber, W., 2011).Hospitalization rates for VTE increased from 3.2 to 17.5 per 100,000 people (Zhang et al., 2019).Summary

Almost all hospitalized patients, as well as many outpatients, require some form of intravenous (IV) catheter, these small plastic tubes are used for administering medications, fluids, nutrition, or blood transfusions, drawing blood samples, or performing dialysis for patients with kidney failure, IV lines are generally categorized into two types: peripheral and central. Peripheral IVs are short, thin catheters inserted into the surface veins of the hand, forearm, or elbow crease. Central venous catheters are longer, larger in diameter, and typically inserted at the upper chest wall or neck, ending where the large veins from the neck and arm meet the heart. Some may be tunneled briefly under the skin before entering the vein, a port a type of central venous catheter, is entirely implanted under the skin and accessed with a small needle to deliver medications or draw blood. Ports (also called portacaths) are often used for chemotherapy patients and are designed for long-term use (American Cancer Society, 2023). A peripherally inserted central catheter (PICC) is another central catheter commonly used in hospitals, inserted into a small vein in the upper arm and ending in the superior vena cava, where the veins from the neck and arm converge with the heart (Evan N, 2018)
 
Central venous access devices (CVADs) can be classified based on factors such as duration of use, tip location, number of lumens, or insertion site Culverwell (E, 2022). A common classification distinguishes implanted from non-implanted devices, CICCs are non-tunneled and typically used for short-term periods (less than 14 days), while PICCs are also non-tunneled but used for longer durations (more than 14 days, up to several months) (Kehagias, E., 2023). Implanted catheters, designed for long-term use, can be tunneled, with a cuff at the skin entry to form a fibrous barrier against pathogens, or they can be PORTs, which feature a subcutaneous reservoir accessed via needle puncture through the skin (Williams L,2005)
CRT, This pertains to the formation of blood clots in the veins and vessel walls surrounding the catheter, due to puncture or mechanical injury to the vessel's inner lining or as a result of the patient's underlying medical condition with the rapid advancement of intravenous infusion technology, central venous catheterization has emerged as an essential component of modern medical practice (Citla Sridhar D, 2020).
CVCs, PICCs, and PORTs have significantly enhanced venous treatment options for patients undergoing emergency care, intensive care, and chemotherapy (Gorski LA, 2021). Hospitalization rates for VTE increased from 3.2 to 17.5 per 100,000 people (Zhang et al., 2019). Multiple factors could contribute to the observed increase, such as population aging, shifts in lifestyle, heightened awareness, and improved detection methods. (Liew et al., 2017; Zhang et al., 2019; Di Nisio, Van & Buller, 2016). Most VTE is preventable (Khan et al., 2021; Liew et al., 2017; Cohen et al., 2007). Preventing the occurrence of VTE is both safer and more cost-effective than treating it once it has developed (Khan et al., 2021). Nevertheless, the execution of VTE prevention measures remains insufficient or unsuitable (Kahn et al., 2018).
CRT risk factors can be grouped into those associated with the catheter, the insertion procedure, and patient-related factors, reflecting Virchow’s triad of endothelial injury, blood flow stasis, and hypercoagulability (Saber, W., 2011). Preventing CRT is more effective than treating it, and some risk factors, such as the catheter's insertion site and type, can be modified. The International Society of Thrombosis and Hemostasis guidelines suggest that, when possible, CVCs should be placed on the right side in the jugular vein, with the tip positioned at the junction of the superior vena cava and right atrium to minimize thrombosis risk (Debourdeau, 2013).
As primary healthcare providers offering direct patient care and spending significant time with individuals, nurses hold a pivotal position in effectively identifying, preventing, and managing VTE in clinical settings (Yan T. 2020). Therefore, it is important for nurses to have a comprehensive understanding of both therapeutic and prophylactic measures against thrombosis to prevent VTE sufficiently occurrences in hospitalized patients (Ma, Y. F., 2018).
Summary