Impact of a Peripheral Vascular Access Service on Device Use

Abstract

Background More than 1 billion peripheral vascular access devices are inserted annually worldwide with potential complications including infection, thrombosis, and vasculature damage. Vasculature damage can necessitate the use of central catheters, which carry additional risks such as central catheter–associated bloodstream infections. To address these concerns, one institution used expert nurses and a consult request system with algorithms embedded in the electronic medical record. Objectives To develop a uniform process for catheter insertion by means of a peripheral vascular access service dedicated to selecting, placing, and maintaining all inpatient peripheral catheters outside of the intensive care units. Methods Descriptive analysis and χ2 analysis were done to describe the impact of the peripheral vascular access service. Results In 2018, 6246 consults were reviewed. Of these, 26% did not require vascular access. Similarly, in 2019, 7861 consults were reviewed, and 35.3% did not require vascular access. Use of central catheters decreased from 21% in 2017 to 17% in 2018 and 2019. Conclusions The peripheral vascular access service allowed patients to receive appropriate peripheral vascular access devices and avoid unnecessary peripheral catheter placements. This may have preserved patients’ peripheral vasculature and thus prevented premature central catheter placement and contributed to an overall decrease in central catheter days. With the peripheral vascular access service, peripheral vascular access devices were selected, placed, and maintained by experts with a standardized process that promoted a culture of quality and patient safety.

CE: Evidence-Based Practice for Peripheral Intravenous Catheter Management

“…In one U.S. study, a dedicated vascular access service of nurses trained to review the need for iv therapy prior to device placement determined that 35% of patients did not require vascular access. 28 The need for clinical expertise and documented competency cannot be overstated. Clinicians responsible for vascular access device insertion and infusion therapy administration must receive appropriate training and perform their duties within their scope of practice, according to licensure regulations and organizational policies and procedures.…”

“…Vascular access specialists should play a major role in determining the appropriate vascular access choice. In one U.S. study, a dedicated vascular access service of nurses trained to review the need for IV therapy prior to device placement determined that 35% of patients did not require vascular access 28…”

Implementación de una unidad de enfermería de acceso vascular: ¿por dónde comenzar?

“…8 En este sentido, se ha descrito que cuando se implementan unidades de enfermeras de acceso vascular disminuye el uso de catéteres venosos entre un 26% y 35,3% el uso de catéter venoso central entre 17% y 21%, demostrando el uso eficiente de los recursos y elección de dispositivo vasculares para las personas que lo requieren. 9 A modo de ejemplo, Scimo et al han descrito múltiples beneficios durante 6 años desde la implementación de EAV cuantificado en 1% de intentos fallidos de instalación de dispositivo vascular, 73% de los PICC instalados en menos de 10 minutos, 90% de los procedimientos con dolor referido por las personas con necesidad del dispositivo menor o igual a 3 puntos utilizando la escala visual análoga del dolor (EVA) e infección asociada al catéter menor al 0,1% del total de los dispositivos instalados por este equipo especializado. Definiendo la efectividad y eficiencia de un equipo de acceso vascular en la instalación y mantención de dispositivos vasculares.…”

The effects of Valsalva maneuver on pain intensity and hemodynamic status during short peripheral cannula insertion in adults: A systematic review and meta-analysis

“…[1][2][3] More than 1 billion SPCs are inserted annually worldwide. 4 SPC insertion leads to physical and psychological complications, including pain. 5 In fact, pain is considered an emotional feeling and experience related to acute or potential tissue damage that is meant for the perception of an internal or external threat.…”