Vascular access is an important part of many patient care management plans but has some unwanted risks. Previous work published by Moureau et al. (2012) inspired a working group led by the UK Infection Prevention Society (IPS) to produce a vessel health and preservation (VHP) framework. This was with the intention of producing a resource for frontline staff to be able to assess and select the best vascular access device to meet the individual patient's needs and to preserve veins for future use. The working group produced a framework that used available evidence, expert opinion and some small scale testing of the components of the framework. The work so far has received positive feedback but further work is required to formally evaluate the VHP framework in clinical practice to measure both staff knowledge and patient outcomes.

No abstract

The field of vascular access has developed significantly over recent decades. It has been adapted to provide a range of techniques for a range of patients much faster than a full appreciation of the risks involved has developed. Improved governance of vascular access procedures in the UK is needed. This is driven by a deeper understanding of risks such as infectious and thrombotic complications, repeated failures of peripheral intravenous (IV) access leading to poor patient experience and treatment inadequacy, and the increasing emphasis on avoiding healthcare-associated infections. The Vessel Health and Preservation (VHP) protocol, which is used to standardise vascular access practice in the US is being evaluated for adoption in the UK. A comprehensive and inclusive approach should be taken to the vascular access needs of all patients.

Parents' perceptions of how they were told that their child has special needs were examined. Thirty-nine families on the Isle of Wight completed a structured interview. Participants formed two groups. The first group comprised of 23 families who had a child aged from birth to 5 years with special needs. In the second group there were 16 families who had a child aged between 15 and 20 years with special needs. Parents were asked about their perceptions of how their child's special needs were disclosed, their satisfaction with how they were told and what improvements they would have liked. Differences between the two cohorts were examined, and changes in how services were perceived were investigated. Overall, parents in the group with younger children were more satisfied about the way in which they were told that their child had special needs than those with older children. Implications for service delivery and future research are considered.

The insertion and care of peripheral intravenous cannulae (PIVCs) is a role performed by clinical staff that is fundamental to oncology. Previous research indicates nurses' confidence and experience could mediate successful first attempt insertion, increasing the longevity of PIVCs and improving the patient experience.The aim of this audit was to provide a snapshot of care and maintenance of PIVCs, patients' experiences and nurses' confidence at a specialist cancer hospital. An audit tool assessing PIVC care practices (n=51) and a patient experience questionnaire (n=65) were completed. A questionnaire assessing nurses' confidence and training needs was completed by 36 nurses.The findings raise some concerns about clinical practice when inserting PIVCs and ongoing care, with 80% adherence to cannulation policies. Almost half of insertion procedures failed at the first attempt and 17% of nurses lacked confidence in PIVC insertion and in recognising or responding to common complications. Patient satisfaction was high for ongoing PIVC care (95%), although some reported increased pain and anxiety after PIVC insertion, with some unresolved concerns.The audit highlights several important areas for improvement in relation to PIVC insertion and maintenance and the need for greater adherence to clinical guidelines/policy and additional training were identified.