Central Line Management Form


You can help by:

  1. Encourage your hospital to use the Central Line Insertion Record SMR090.200
  2. Review and provide feedback on prototype Central Line Management Form below.

Despite the nurse indicating that there had been a verbal request for the removal of the patient’s central line, there was no written documentation that this should take place, and no clear indication why….

One form for central line documentation used across all healthcare facilities will allow us to generate strong data to review the equipment and processes involved.

We encourage all hospitals and staff in NSW to use the:

Central Line Insertion Record SMR090.200

Supplied by:
Salmat Printing on Demand, 2 Military Road, Matraville.
Tel 93119899
Fax 93111076
Catalogue supply number: NH606515

We believe that, in time, the ‘Central Venous Line Insertion Record’ could be improved upon and simplified to focus on the important aspects of central line management from request through to removal, allowing us to record the most useful data. We could generate a more powerful tool for reviewing the processes and equipment we use.

Ultimately it would be ideal to create an electronic form, however until an electronic form can be accessed readily and easily by staff at all hospitals data capture will be greater with a paper form.

We value your feedback on the mock form below in order to refine it prior to trial: