SAS and Push-Stop-Push techniques to prevent CVC occlusion in hospitalized patients

Álvaro N. López-Sabino, Subdirección de Enfermería, Hospital Naval de Acapulco, Dirección General Adjunta de Sanidad Naval, Acapulco, Guerrero, México
Loreyda Méndez-del Ángel, Subdirección de Enfermería, Hospital Naval de Acapulco, Dirección General Adjunta de Sanidad Naval, Acapulco, Guerrero, México
Samantha N. Mota-Jiménez, Sección de Investigación, Escuela de Enfermería Naval, Secretaría de Marina, Ciudad de México. México
Joel Martínez-Martínez, Departamento de Enfermería del Adulto en Estado Crítico, Centro Médico Naval, Secretaría de Marina, Ciudad de México, México

Introduction: The use of central venous catheters (CVCs) in hospitalized patients is associated with complications such as occlusion, which is one of the most common and may interrupt the patient’s treatments. In this regard, the best approach nursing staff can take is prevention through effective methods. Objective: To evaluate the effectiveness of the SAS (Saline, Administration of medication, Saline) and Push-Stop-Push techniques, applied sequentially, in preventing CVC occlusion in hospitalized patients. Method: An observational, longitudinal, and prospective study was conducted in 35 patients with CVCs hospitalized in general wards, intermediate, and intensive care units between January and April 2025. The SAS and Push-Stop-Push techniques were applied, and catheter patency was assessed at three time points: day 1 (before protocol implementation), day 3, and day 7 (after application of the techniques). Statistical analysis included McNemar’s test and Cochran’s Q test to compare the incidence of occlusion at different time points. Results: On day 1, an occlusion rate of 28.6% was observed, decreasing to 17.1% on day 3 and to 5.7% on day 7. McNemar’s test showed a statistically significant reduction by day 7 (p = 0.008). Cochran’s Q test confirmed a significant trend in the reduction of occlusions (p = 0.018). An association was also identified between CVC occlusion on day 7 and the use of the left jugular vein as the insertion site (p = 0.014). Conclusions: The sequential application of SAS and Push-Stop-Push techniques significantly reduces the frequency of CVC occlusions in hospitalized patients, improving catheter patency and contributing to clinical safety.

Keywords: Central venous catheter. Occlusion. SAS technique. Push-Stop-Push technique. Nursing.