Championing Patient Safety through Vessel Health and Preservation with Vascular Access Specialist Teams
At its essence , the objective of the VHP model is to “ improve quality of care , reduce risks associated with vascular access devices ( VADs ), and increase patient satisfaction and efficiency in the use of healthcare resources .”
By Kelly M . Pyrek
The quest for a patient-centered protocol for the management of vascular-access devices began more than a decade ago , when practitioners knew they needed to mesh the concept of the use of the right line , for the right patient , at the right time , with an initiative that reduced clinical and economic risks associated with vascular access use and delivery of infusion therapies . Coming to fruition in 2019 was publication of an initiative “ founded upon a philosophy in which a patient ’ s vasculature and historical use of veins for infusion therapy would be considered and prioritized as a key healthcare objective .” ( Trick , 2019 ) This initiative championed patient-specific vascular access assessment from an emergency department visit through admission , discharge and beyond in the healthcare spectrum .
As Moureau ( 2019 ) explains , the vessel health and preservation ( VHP ) is “ a model applied to vascular access and the administration of IV medications and treatment that structures evidence-based practices within four quadrants of medical care : assessment / selection , insertion , management , and evaluation of vascular access devices . The model incorporates evidence-based practices , guidelines , and recommendations from many countries to guide practice from patient admission through completion of treatment . Application of the VHP is designed to ensure a higher level of safety for the patient , reduce risk with device selection , limit negative consequences of insertion using specially trained clinicians , promote complication-free device longevity through proper care and maintenance practices , and complete the process by evaluating and removing devices as soon as treatment is completed .”
At its essence , the objective of the VHP model is to “ improve quality of care , reduce risks associated with vascular access devices ( VADs ), and increase patient satisfaction and efficiency in the use of healthcare resources ,” according to Moureau ( 2019 ). The model consists of four clinical pathways – a step-wise process for management of patient care that promotes efficiency within a defined group of patients , those requiring vascular access devices , during the treatment process – designed to improve patient outcomes by reducing variability , adding standardization , and reducing medical errors .
The first pathway is assessment / selection and incorporates :
● Evaluation of patient risk and vein choices
● Selection of devices for therapy and duration
● Validation of device-specific indications
● Selection of device size based on vein size
● Verification of the number of lumens required
The second pathway is insertion and incorporates :
● Insertion performed by qualified / trained inserter
● Application of surgical-ANTT with maximal barrier precautions for CVADs
● Verification of CVAD terminaI tip using EKG / x-ray
● Use of securement and antimicrobial dressing
The third pathway is management and incorporates :
● Performance of daily assessment of site , device function , securement and dressing
● Use of ANTT for all access
● Identification , management and prevention of complications
● Evaluation of device necessity ; removal when no longer medicaIly necessary The fourth pathway is evaluation and incorporates :
● Performance of patient-outcome audits of complications
● Evaluation of staff competency , infection prevention compliance and educational needs
● Establishment of a formal process for product evaluation
VHP ’ s focus on delivering the highest quality of patient care through evidence-based practice extends to the use of vascular access devices ( VADs ) that ensure :