REVIEW A review of the nursing role in central venous cannulation: implications for practice policy and research Evan Alexandrou, Timothy R Spencer, Steve A Frost, Michael JA Parr, Patricia M Davidson and Kenneth M Hillman Aims and objectives. The aim of this article is to review published studies about central vein cannulation to identify implications for policy, practice and research in an advanced practice nursing role. Design. Modified integrative literature review. Methods. Searches of the electronic databases: Cumulative Index of Nursing and Allied Health Literature (CINAHL); Medline, Embase, and the World Wide Web were undertaken using MeSH key words. Hand searching for relevant articles was also undertaken. All studies relating to the nurses role inserting central venous cannulae in adult populations met the search criteria and were reviewed by three authors using a critical appraisal tool. Results. Ten studies met the inclusion criteria for the review, all reported data were from the UK. There were disparate models of service delivery and study populations and the studies were predominantly non experimental in design. The results of this review need to be considered within the methodological caveats associated with this approach. The studies identified did not demonstrate differences in rates of adverse events between a specialist nurse and a medical officer. Conclusions. There were only a small number of studies found in the literature review and the limited availability of clinical outcome data precluded formal analysis from being generated. Relevance to clinical practice. Central vein cannulation is potentially an emerging practice area with important considerations for policy practice and research. Training specialist nurses to provide such a service may facilitate standardising of practice and improving surveillance of lines, and possibly improve the training and accreditation process for CVC insertions for junior medical officers. For this to occur, there is a need to undertake well-conducted clinical studies to clearly document the value and efficacy of this advanced practice nursing role. Key words: central venous cannulae, critical care, Health Services Research, multiprofessional care, nurses, nursing Accepted for publication: 16 January 2009 Introduction Central venous access in contemporary clinical practice Central venous cannulae (CVCs) are used for delivering vesicant medications, long term intravenous therapy, paren- teral nutrition, and in some instances for individuals with poor peripheral venous access. The CVC is also used in critical care settings for haemodynamic monitoring (Taylor & Palagiri 2007). While traditionally confined within spec- ialised areas such as intensive care units and operating theatres, central venous cannulation is being adopted across Authors: Evan Alexandrou, RN, B.Health, ICU Cert, MPH, PhD Candidate, Clinical Nurse Specialist, Centre for Cardiovascular and Chronic Care, Curtin University of Technology, Sydney, NSW, Australia; Timothy R Spencer, RN, B.Health, ICU Cert, Clinical Nurse Consultant, Sydney South West Area Health Service, Intensive Care, Sydney, NSW, Australia; Steve A Frost, RN, ICU Cert, MPH, PhD Candidate, Associate Lecturer, School of Nursing, Sydney, University of Western Sydney, NSW, Australia; Michael JA Parr, FRCP, FRCA, FANZCA, FJFICM, Director of Intensive Care, University of NSW, Sydney, NSW, Australia; Patricia Mary Davidson, RN, PhD, Professor, Centre for cardiovascular and Chronic Care, Curtin University of Technology, Chippendale, NSW, Australia; Kenneth M Hillman, MD, MBBS, FRCA, FANZCA, FJFICM, Professor, University of NSW, Sydney, NSW, Australia Correspondence: Evan Alexandrou, Liverpool Hospital, Intensive Care, Locked bag 7203, Liverpool BC, Sydney, NSW 1871, Australia. Telephone: +02 98283603. E-mail: e.alexandrou@uws.edu.au Ó 2009 Blackwell Publishing Ltd, Journal of Clinical Nursing 1 doi: 10.1111/j.1365-2702.2009.02910.x