Vascular access is an important component of health care but is not without associated risks, some of which can be life-threatening. The Vessel Health and Preservation (VHP) framework was developed with the intention of providing frontline staff with a resource to assist in assessing and selecting the best vascular access device to meet individual patient needs and to preserve veins for future use. This article examines the impact of the introduction of the framework into a haematology ward in an acute hospital in the North West of England during a 3-month pilot study. The results indicate that the VHP framework gave nursing staff more autonomy to choose the appropriate vascular access device for their patients and improved staff knowledge around pH and osmolality of intravenous drugs. However it is clear that more in-depth evaluations need to be conducted to assess the impact of VHP on patient care and outcomes.

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The aim of this article is to enable nurses to understand the powerful role of organisational culture in influencing the effectiveness of healthcare delivery, primarily within the British National Health Service (NHS). After reading this article and completing the time out activities, you should be able to: Describe what organisational culture is within a healthcare setting through an examination of various theoretical frameworks. Understand the role of organisational culture and its importance in influencing effective healthcare delivery. Reflect on some of the steps that can be undertaken to improve organisational culture in the healthcare setting. Relevance to The Code Nurses are encouraged to apply the four themes of The Code: Professional Standards of Practice and Behaviour for Nurses and Midwives to their professional practice (Nursing and Midwifery Council (NMC) 2015). The themes are: Prioritise people, Practise effectively, Preserve safety, and Promote professionalism and trust. This article relates to The Code in the following ways: Nurses are enabled to practise effectively by being aware of the power and role of organisational culture in influencing healthcare delivery. The Code states that nurses should act in partnership with those receiving care, helping them to access relevant information and support when they need it. By examining organisational culture, the underpinning values and beliefs, which should encompass patient-centred care, and working in partnership with patients, can be explored and examined. The Codes states that nurses should be a model of integrity and leadership for others to aspire to. Leadership and role modelling forms an integral part of maintaining an effective organisational culture and encourages others to work to the values and beliefs that underpin 'the way things are done around here'.

Leadership is one of the most discussed concepts within healthcare. It is well established that leadership is linked to patient safety and this has been demonstrated for several years through high-profile reports investigating suboptimal care in healthcare organisations. Because of the importance of leadership within healthcare, it is essential that nurses understand the term leadership and what it means to healthcare practice. There is a drive for leadership at all levels of healthcare organisations. This article will explore how leadership at all levels is accomplished using collective leadership and outlines the behaviours and qualities required to develop and sustain this approach to leadership.