In the timeframe from insertion to removal it is necessary for staff to have education on proper daily assessment , systematic review of key points covered in the VHP cycle .” complications can include mechanical and infectious complications as well as thrombotic complications . The most critical insertion-related complications include pneumothorax , nerve damage and major artery puncture and may occur in up to one in six catheter insertions … The right education and training in VAD insertion have a positive impact on reducing central line-associated bloodstream infectious complications . The primary goal of VHP is to reduce risk associated with the insertion and management of VADs ; this can be achieved through infection prevention education .”
“ In the timeframe from insertion to removal it is necessary for staff to have education on proper daily assessment , systematic review of key points covered in the VHP cycle and within publications such as Gillian Ray-Barruel ’ s I-Decided Assessment tool ,” Moureau emphasizes . “ By following a checklist or educated assessment of the device , the insertion site , the dressing , and the ongoing need for the IV the clinician can ensure patient safety , avoiding many common complications and the most serious of infection .”
She continues , “ The last quadrant of VHP is focused on audit / evaluation and education for identified gaps . Only the highest quality-minded , patient-centered organizations do this . By performing data collection and analysis of patient outcomes with all VADs , peripheral and central , do we gain a clear picture of areas that need improvement . The real key to a high-quality program is having a specialized team to insert and monitor VADs . Research suggests this as the approach that achieves the best outcomes for patients and represents a very high quality , safety minded approach . What many hospitals do not realize is that this approach has the potential to save the organization millions of dollars , they see establishing and maintain teams as a cost and not reflective of savings .”
Carr and Moureau ( 2019 ) acknowledge that vascular access in many hospitals is fragmented , and that specialization is an idea whose time has come : “ When a patient is admitted to a hospital , they are invariably exposed to a variety of invasive VAD procedures . Many will receive clinical interventions
from different professional roles , all with different levels of experience following specific professional guidelines . Such a strategy is best represented as an interdisciplinary sharing method : one entity for insertion and another for care and maintenance . This process has resulted in responsibility for VADs being fragmented and this process identified as an increased patient safety risk . Specialist medical care is not so fragmented , for example , in specific healthcare domains of cardiology , orthopedics , pediatrics and others all providing a higher level of quality care within their area of specialization . Therefore , it is important that highly skilled clinicians or specialists are available to improve VAD outcomes , ideally adopting a VHP approach .”
The experts emphasize that despite the uninformed suggesting that vascular access is a “ generic skill or a clinical procedure absorbed into other competing clinical responsibilities and professional domains ,” vascular access demands a specialist healthcare profession to ensure maximum patient safety : “ Despite the pervasive use of VADs and associated technologies , the ownership of its term as a specialty or specialist team is in its infancy . This means high-level evidence for the specialty and teams is also lacking . Notwithstanding this reality , it is worth exploring the contribution of a vascular access specialist and team approach has made to patients ’ health and on the patient experience . Moreover , how a team approach can be adopted into a future where a safety science culture is likely to become commonly accepted in healthcare and where it can demonstrate sustained value as an authority on vascular access quality and safety . The adoption and use of VHP and a vascular access specialist team ( VAST ) will add important and timely insights into a concept eager for clinical validation .”
References :
Alexandrou E , Mifflin N , and Carr PJ . Training and Education . In : Vessel Health and Preservation : The Right Approach for Vascular Access . Ed : Moureau NL . Springer . 2019 .
Carr PJ and Moureau NL . Specialized Vascular Access Teams . In : Vessel Health and Preservation : The Right Approach for Vascular Access . Ed : Moureau NL . Springer . 2019 .
Moureau NL . The VHP Model . In : Vessel Health and Preservation : The Right Approach for Vascular Access . Ed : Moureau NL . Springer . 2019 .
Moureau NL , Carr PJ . Vessel Health and Preservation : a model and clinical pathway for using vascular access devices . British Journal of Nursing . 2018 Apr 26 ; 27 ( 8 ): S28-35 .
Moureau NL , Trick N , Nifong T , Perry C , Kelley C , Carrico R , Leavitt M , Gordon SM , Wallace J , Harvill M , Biggar C . Vessel health and preservation ( Part 1 ): a new evidence-based approach to vascular access selection and management . The journal of vascular access . 2012 Jul ; 13 ( 3 ): 351-6 .
Steere L , Ficara C , Davis M , Moureau N . Reaching One Peripheral Intravenous Catheter ( PIVC ) Per Patient Visit With Lean Multimodal Strategy : the PIV5Rights™ Bundle . Journal of the Association for Vascular Access . 2019 ; 24 ( 3 ): 31-43 .
Trick N . Foreword , page V . In : Vessel Health and Preservation : The Right Approach for Vascular Access . Ed : Moureau NL . Springer . 2019 .