Simulation focused on identifying sterile versus non-sterile and how to manage supplies is needed to reinforce safe practices among clinicians . Consideration for location and appropriate vein selection can limit catheter movement , minimize catheter failure due to accidental dislodgment and set the stage for better outcomes as noted in the Wallis study . Additional specialized training and designation of vascular access specialists or teams results in more consistent first-time success and vein preservation as noted in the Steere study . Establishing competency requirements for 90 percent success on first attempt can guide the selection of qualified inserters , promoting trust and safety for the patient .
By managing policies for safe insertion practices through education and clinically indicated PIVC replacement with assessment practices monitored on a consistent basis , complications free survival of PIVC can be achieved . The cost associated with the volume and frequency of PIVC insertions , and the current level of failure touches all patients and bedside clinicians . But even more so , those same factors impact the bottom line for chief financial officers and chief executive officers of hospitals , whether they realize it or not . PIVCs and ultrasound guided peripheral catheter insertions are increasing making PIVC failure and poor practices a target for performance improvement initiatives . With the increasing concern over limited financial resources in acute care more attention should be given to the undervalued PIVC .
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Nancy Moureau , RN , PhD , CRNI , CPUI , VA-BC , is the chief executive officer at PICC Excellence , Inc ., a research member of the Alliance for Vascular Access Teaching and Research ( AVATAR ) Group , and an adjunct associate professor at Griffith University in Brisbane , Australia .
References :
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https :// doi : 10.1177 / 1757177417720996
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Strategies to reduce PIVC complications begin with education on the basic education emphasizing aseptic non touch technique , increasing clinician understanding of clean practices , skin antisepsis leading to good skin preparation prior to insertion .
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