Introduction: Vascular access is the most common invasive procedure performed in health care. This fundamental procedure must be performed in a safe and effective manner. Vascular access devices (VADs) are often the source of infections and other complications, yet there is a lack of clear guidance on VADs for health providers across different settings. A Best Practice Guideline (BPG) was developed by the Registered Nurses’ Association of Ontario (RNAO) to provide evidence-based recommendations on the assessment and management of VADs. Methods: RNAO BPGs are based on systematic reviews of the literature following the GRADE approach. Experts on the topic of vascular access were selected to form a panel. Systematic reviews were conducted on six research areas: education, vascular access specialists, blood draws, daily review of peripheral VADs, visualization technologies, and pain management. A search for relevant research studies published in English limited to January 2013 was applied to eight databases. All studies were independently assessed for eligibility and risk of bias by two reviewers based on predetermined inclusion and exclusion criteria. The GRADE approach was used to determine certainty of the evidence. Results: Over 65,000 articles were screened related to the six priority research questions. Of these, 876 full-text publications were examined for relevance, with 174 articles designated to inform nine recommendations in the BPG on the subject areas of: comprehensive health teaching, practical education for health providers, blood draws, daily review of peripheral VADs, visualization technologies, and pain management. In June 2021, the RNAO published the BPG on vascular access, which included the recommendations and other supporting resources. Conclusion: The vascular access BPG provides high quality guidance and updated recommendations, and can serve as a primary resource for health providers assessing and managing VADs.

The ways in which language provides the bases for trust as an interpersonal construct, personally and organizationally, locally and globally, are elegantly explored in Salvi and Turnbull's volume of essays, The Discursive Construal of Trust in the Dynamics of Knowledge Diffusion. Culminating from a 2015 workshop organized by the CLAVIER Centre (Corpus Linguistics and Language Variation in English Research), each chapter turns to specific contextual examinations of identity formation and image construal, all focused on the slippery notions of trust, which, like love or obscenity, are easier identified than described, quantified, or studied in any meaningful way. Trust, mired as it is in images of self, other, and the worlds around us, perceived or imagined, is examined here minutely. This volume presents scholarship that extends existing research, examines current multimodal practices (websites, face-to-face interactions), and makes recommendations of best practices for those seeking solutions. This review will highlight specific essays for outstanding features and contributions to the dialogues of scholarship upon which they are built. Web-based building of trust can be found in many of the chapters, and built as they are upon solid empirical data, these chapters provide rich insight into multimodal discourse. Because websites are (relatively) fixed spaces and are intended for (relatively) general audiences, they become ample fodder for scholarly reflection. We are reminded that multimodality is not new: It is, in fact, the normal state of communication, given that images predate script. The book's first section focuses upon building trust. Salvi's chapter 1 takes on German Chancellor Angela Merkel's official website and centers on the dynamic and potentially dangerous topical waters of migration, immigration, refugees, and the construal of a European identity that is both collective and yet maintains individual nation status. Salvi finds strategies built upon pronominals and modal verbs. Rhetorical tropes such as repetition are briefly examined also. Of peripheral interest to this study is the genre of the official website itself, which Salvi refers to as a "mixed genre" as it includes "narration of events and quotations from the Chancellor's speeches" (p. xvi), and functions intersectionally as a primary 738037J LSXXX10.

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