The evidence
shows us that
each patient
requires on
average
2.5 attempts
to start an
IV, and the
average
catheter
lasts only
2.1 days.
During an
average 5 day
stay, a patient
will be poked
5.9 times
to maintain
access.
HHM How can this specialist/team boost
everyone’s performance and fight HAIs?
G&P: Let’s face it, any time we break the skin
we put our patients at risk for a bloodstream infec-
tion. Bacteria are opportunistic and pathogens are
not specific to central catheters only. The problem
is that we are only looking at central catheters.
If we have dedicated nurses placing PIVs on the
first attempt with good technique, we can reduce
bloodstream infections.
HHM If a hospital is ready to hire, what are
some best practices for moving forward to
finding the right individual/create the most
effective team?
G&P: Being on a VAT is a high demand role.
When I was hiring for my team, I looked for
someone that could walk fast and be on their
feet all day but most importantly someone with a
can-do attitude. A saying that resonates with me
is “Hire for attitude, train for skill.” This person
should be a nurse who could advocate for the
patient, understand the current standards, and
challenge the current practices without making
adversaries to the team. The VAS must establish
excellent relationships with physicians. It is through
multidisciplinary collaboration that we can place
the right device for our complex patients today.
It is with this type of collaboration that Sheri and
I were able to place our first mid-thigh femoral
PICC. We had Matt Ostroff, a VAS from New Jersey
on the phone, our interventional radiologist and
our ICU intensivist collaborating together to decide
on the most appropriate device for the patient.
Patient care requires teamwork and working well
with other providers is crucial.
HHM How can nurses and other healthcare
stakeholders voice their perspectives about
the need for a specialist/team to hospital
leadership so they are heard and action
is taken?
G&P: We already have specialized nursing
care, such as our cardiovascular intensive care unit
nurses, our neonatal nurses, and our wound/IC
nurses. Vascular access should be no different.
Today’s patients are coming in sicker and more
complex than ever. The evidence shows us that
each patient requires on average 2.5 attempts to
start an IV, and the average catheter lasts only 2.1
days. During an average five-day stay, a patient
34
will be poked 5.9 times to maintain access. From
a patient’s perspective, this hurts. From a financial
perspective, these 5.9 attempts can be costly to
a hospital. According to the literature, IV-starts
on average cost $35 each attempt. Sure, $35
doesn’t seem like a lot, but if you have a 450-bed
community hospital with an average daily census
of 325, cost savings can add up quickly. The para-
digm has shifted since the 1970s IV teams. Current
teams desire to place a broader range of devices,
really pushing the boundaries of the specialty and
encompassing the patient as a whole. This means
proactive insertion of the appropriate device on
the first attempt, with the goal being that device
is the one that completes therapy. This means
owning the outcomes, taking responsibility for
the complications, providing education, reducing
waste and healthcare costs, while increasing
patient, nurse, and hospital satisfaction.
HHM How can nurses and other healthcare
stakeholders lobby their representatives and
senators about the need for political action,
and what is the eventual desired outcome
on Capitol Hill?
G&P: We have joined AVA along with other
vascular access specialists and have formed a
public policy task force. Part of our goal is to
create awareness around lobbying, draft letters
for healthcare stakeholders to send to their
representatives and senators about the impact of
a dedicated team, much like wound and infection
preventionist have had on patient care. These
devices have risks and complications and can
no longer be overlooked. Our goal is to have a
vascular access specialist in every hospital across
America to provide education, competency, place
devices, advocate, research, and own the device
outcomes for patients and the hospitals they
get care from. We want this message of having
a dedicated team that owns the outcomes of
device placement and the ability to save healthcare
dollars, much like our infection preventionists and
wound care nurses have impacted patient care and
outcomes, to be loud and clear. Our short-term
goal is to have a nurse from each state join us
on Capitol Hill on June 19, 2020. The long-term
goal is that we will have a highly skilled clinicians
placing the right device, based on the infusates
and duration, for the right patient, based on a
full assessment and at the right time early in
admission for all patients in America. Doing so
will save healthcare dollars, reduce complications
and improve patient satisfaction.
february 2020 • www.healthcarehygienemagazine.com