With the growing number of children and young people with complex care needs or life-limiting conditions, alternative routes for nutrition have been established (such as gastrostomy feeding). The conditions of children and young people who require such feeding are diverse but could relate to problems with swallowing (dysphagia), digestive disorders or neurological/muscular disorders. However, the use of a blended diet as an alternative to prescribed formula feeds for children fed via a gastrostomy is a contentious issue for clinicians and researchers. From a rapid review of the literature, we identify that current evidence falls into three categories: (1) those who feel that the use of a blended diet is unsafe and substandard; (2) those who see benefits of such a diet as an alternative in particular circumstances (eg, to reduce constipation) and (3) those who see merit in the blended diet but are cautious to proclaim potential benefits due to the lack of clinical research. There may be some benefits to using blended diets, although concerns around safety, nutrition and practical issues remain.

In today's ever-changing acute care setting, justifying the allocation of resources for development and implementation of a Vascular Access Team (VAT) can often be challenging. The Infusion Nurses Society (2000), which establishes standards of practice for the infusion nursing profession, states that "the profession itself must seek control of its practice to assure the quality of its services to the public. A profession's concerns for quality services reflects its commitment to serving the community." This article discusses the steps that were taken in the development of a VAT in the acute care setting of Froedtert Memorial Lutheran Hospital, a teaching hospital affiliated with the Medical College of Wisconsin.

Background: Peripheral intravenous (PIV) management requires knowledge, skill, and clinical judgment to ensure positive patient outcomes; yet, many nurses lack confidence in their PIV knowledge and skills. It is important that graduate nurses acquire PIV knowledge and skills in nursing school. This study aimed to explore PIV content coverage and clinical opportunities provided in U.S. and Canadian nursing curricula. Method: Using a descriptive, exploratory design, representatives of nursing schools completed a 12-item, web-based PIV curriculum survey. Results: Most schools covered PIV content in classroom, laboratory, and clinical settings; however, some indicated students were not allowed to initiate PIVs in clinical settings. Participants noted that PIV education was a shared responsibility with health systems. Conclusion: It is important that nursing students develop PIV competence; however, competing pressures for time in nursing curricula may limit PIV coverage. Nurse educators can benefit from PIV and infusion therapy specialty organization resources. [ J Nurs Educ . 2020;59(9):493–500.]

Background: Greater than 90% of hospitalized patients receive some form of peripheral intravenous therapy for the delivery of fluids, medication, or parenteral nutrition. Nurses are the largest group of clinicians responsible for the placement and management of peripheral intravenous therapies. The literature suggests that many graduate nurses lack the confidence, knowledge, and ability to not only place peripheral intravenous catheters, but also adequately maintain peripheral intravenous sites. This fact, combined with the increasing acuity of hospitalized patients with multiple comorbidities, makes peripheral intravenous placement and management even more challenging. This drove a team of researchers to explore the current state of peripheral intravenous education in health care institutions and examine potential gaps in ongoing professional development and competency assessment. Methods: A convenience sample of United States and Canadian health care institution representatives were recruited to participate in a 12-item web-based questionnaire regarding peripheral intravenous education and staff competency. Participants were recruited via the Association for Vascular Access listserv, newsletter, and annual meeting. Members were also asked to forward the recruitment e-mail to other health care institutions to ensure a representative sample. Results: A total of 611 health care institution representatives participated in the study. The large majority (80%) worked in a health care institution with more than 150 beds. Over half (67%) indicated that they provide peripheral intravenous education to their staff using varying modalities to deliver the education. The majority (54%) of health care institutions reported spending between 1 and 5 hours on peripheral intravenous education while, alarmingly, 38% reported spending less than 1 hour on peripheral intravenous education for their staff. Despite these numbers, over half of the participants (58%) believe peripheral intravenous education is a shared responsibility between pre-licensure nursing schools and health care institutions. Discussion: The study highlights the varying level of peripheral intravenous education and competency evaluation of staff working in health care institutions. The results suggest the need for an evidence-based, standardized peripheral intravenous curriculum that could be used in both health care institutions and nursing education programs. Conclusion: Currently, there are inconsistencies in the peripheral intravenous education and competency programs used in health care institutions. The authors will use the results of this study to design and examine the effects of a standardized, evidence-based peripheral intravenous curriculum to assist health care professionals responsible for peripheral intravenous education and competency assessment. Given the risk for complications from peripheral intravenous therapy, it is hoped that improved peripheral intravenous education will reduce potential complications and improve patient outcomes.

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