A Quality Improvement Project to Decrease CLABSIs in Non-ICU Settings.

Background And Objectives: Central line-associated bloodstream infections (CLABSIs) are a common, preventable healthcare-associated infection. In our 3-hospital health system, CLABSI rates in non-intensive care unit (ICU) settings were above the internal target rate of zero. A robust quality improvement (QI) project to reduce non-ICU CLABSIs was undertaken by a team of Doctor of Nursing Practice (DNP)-prepared nurse leaders enrolled in a post-DNP Quality Implementation Scholars program and 2 QI experts.

Making the Most of Midlines: A Retrospective Review of Outcomes.

Decision-making for vascular access device selection is becoming increasingly complex as new technologies come to market and efforts to reduce central line-associated bloodstream infections increase. This retrospective review of 165 midline catheter outcomes was undertaken after a cluster of unexpected failures occurred in a large academic medical center in the southeastern United States. Mean dwell time for midline catheters was 8.

Vascular Access Device Care and Management: A Comprehensive Organizational Approach.

The Infusion Nurses Society asserts that a comprehensive organizational approach to vascular access device (VAD) care and management is imperative to ensure safe and efficacious patient care. It is essential that each organization (1) develops policies and procedures to align VAD care and management with recognized standards of practice; (2) integrates unique aspects of organization-selected VAD care products into policies and procedures and establishes expectations for adherence to these organizational directives; (3) develops a framework for gathering and analyzing clinical data related to patient outcomes for VAD care and management; (4) utilizes quality outcome data to facilitate evidence-based best practices within the organization; and (5) evaluates and facilitates educational programming to validate clinician competency.

Investigation of the role of infusate properties related to midline catheter failure in an ovine model.

Purpose: Infusate osmolarity, pH, and cytotoxicity were investigated as risk factors for midline catheter failure.

Methods: An experimental, randomized, controlled, blinded trial was conducted using an ovine model. Two 10-cm, 18-gauge single-lumen midline catheters were inserted into the cephalic veins of sheep.

CE: Original Research: Does Certification in Vascular Access Matter? An Analysis of the PICC1 Survey.

Unlabelled: : Background: Although certification by an accredited agency is often a practice prerequisite in health care, it is not required of vascular access specialists who insert peripherally inserted central catheters (PICCs). Whether certification is associated with differences in practice among inserters is unknown.

Purpose: The purpose of this study was to gather information regarding whether certified and noncertified PICC inserters differ with respect to their practices and views about PICC use.

Understanding the Patient Experience of Peripherally Inserted Central Catheter-Related Deep Vein Thrombosis Using Interpretive Phenomenology.

The purpose of this interpretive phenomenological study was to determine what it means to patients to live with a peripherally inserted central catheter (PICC)-related deep vein thrombosis and to describe the influence of the experience on the individual's quality of life. The sample included 11 adult patients from an acute care setting who developed a PICC-related symptomatic thrombus between November 2014 and March 2016, using purposive sampling. Three distinct themes emerged from the data in this study: a loss of trust in health care providers, additional burdens to existing problems, and a yearning for understanding.

Obtaining Coagulation Blood Samples From Central Venous Access Devices: A Review of the Literature.

Background: Central venous access devices are used for chemotherapy and other medication administration, blood product administration, parenteral nutrition, and for obtaining blood samples in patients where the vasculature is difficult to access. Patients may need additional blood samples prior to invasive procedures and when clinical situations arise during cancer care. In addition, monitoring coagulability through ongoing blood testing is common in patients with cancer and requires repeated sampling to adjust anticoagulant medications.

Broadening infusion specialization as an adjunct to organizational sustainability.

As changes in reimbursement structures create a stringent focus on the prevention of infection and other infusion-related complications that predispose to infection, it becomes important to examine the impact of vascular access and infusion specialty practices and procedures on overall organization sustainability and to implement strategies for disseminating infusion expertise to a broader contingent of nurses. This article discusses infusion nursing practice as it impacts the organization as a whole and details a performance improvement initiative for implementing a novel peripherally inserted central catheter tip determination technology that encompasses many of the goals of the industry standards.

Developing an alternative workflow model for peripherally inserted central catheter placement.

Many challenges face vascular access nurses as technology improves and patients require more numerous and lengthy intravenous therapies. Nurses began placing peripherally inserted central catheters (PICCs) at the patient bedside in an effort to defray costly interventional radiology procedures and provide for patient comfort. In recent years, the numbers of PICC procedures have increased, and the procedure itself has become more technologically advanced.

Implementing and maintaining an infusion alliance.

Infusion therapy models are ever changing and growing in modern health care. New technologies and problems arise daily as researchers and clinicians explore our world. As technologies advance, health care costs are also skyrocketing.