Vascular Access Device Care and Management

Abstract

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.

Qualitative interviews and supporting evidence to identify the positive impacts of multidisciplinary vascular access teams

“…Current literature indicates that insertion practice variation and a lack of standardization leads to device-associated IV complications that persist when there is no VAT. Variation in practice is still a challenge that continues to jeopardize patient safety [5], but this can be overcome with a dedicated VAT [1,14].…”

“…Inserting a VAD is not without complications, and there are many concerns about the risks associated with VADs that represent patient harm and financial burden [4,5]. The most common catheter-related complications (CRCs) are infection, malfunction, thrombosis, and IV failure [1,4].…”

“…The most common catheter-related complications (CRCs) are infection, malfunction, thrombosis, and IV failure [1,4]. There is an overall catheter failure rate of 35% to 50%, which results in thrombosis, phlebitis, infiltration, occlusion/mechanical failure, dislodgment, infiltration and extravasation, and infection [1,[5][6][7]. Among the CRCs, catheterrelated bloodstream infection (CRBSI) have one of the highest healthcare burdens in terms of costs, patient length of stays, and morbidity with an attributable mortality ranging from 12% to 25% [4,[8][9][10].…”

“…Preventing such complications is a healthcare priority [9,11], and when optimally managed, inserting a VAD can be performed with low incidence of CRCs [4,12]. It has been asserted that a comprehensive organizational approach to VAD care and management is imperative to ensure safe and efficacious patient care [5]. A dedicated vascular access team (VAT) (sometimes also known as infusion or intravenous therapy teams) can help develop, implement, and standardize policies for VADs that address insertion, maintenance, and removal as well as education for nursing staff Table 1.…”

“…Over the past few years, VATs have been established in many (but not all) European Institutions, with the perception that they may improve hospitals' efficiency and patient safety and reduce costs [5]. Nevertheless, clear evidence of those benefits is still lacking.…”