Impact of a Peripheral Vascular Access Service on Device Use.

Background: More than 1 billion peripheral vascular access devices are inserted annually worldwide with potential complications including infection, thrombosis, and vasculature damage. Vasculature damage can necessitate the use of central catheters, which carry additional risks such as central cathe...

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Published in:American Journal of Critical Care Vol. 30; no. 4; pp. 295 - 302
Main Authors: Wells, Celia, Zhang, Ziya, Chan, Christy, Brito, Amy, Kohli-Seth, Roopa
Format: algorithm research tables/charts Journal Article
Published: American Association of Critical-Care Nurses Jul2021
Online Access:View this record in EBSCOhost
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      dt: Jul2021
      vid: 30
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      pub: American Association of Critical-Care Nurses
      place: Alisa Veijo, California
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        10.4037/ajcc2021425
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        atl: Impact of a Peripheral Vascular Access Service on Device Use.
      aug:
        au:
          Wells, Celia
          Zhang, Ziya
          Chan, Christy
          Brito, Amy
          Kohli-Seth, Roopa
        affil: Celia Wells is senior director of nursing for critical care, Icahn School of Medicine at Mount Sinai, New York, New York.
      sug:
        subj:
          Catheterization, Peripheral
          Catheters, Vascular Utilization
          Intensive Care Units
          Quality Improvement
          Human
          Descriptive Research
          Chi Square Test
          Central Venous Catheters
          Funding Source
          Inpatients
          Patient Safety
      ab: Background: More than 1 billion peripheral vascular access devices are inserted annually worldwide with potential complications including infection, thrombosis, and vasculature damage. Vasculature damage can necessitate the use of central catheters, which carry additional risks such as central catheter–associated bloodstream infections. To address these concerns, one institution used expert nurses and a consult request system with algorithms embedded in the electronic medical record. Objectives: To develop a uniform process for catheter insertion by means of a peripheral vascular access service dedicated to selecting, placing, and maintaining all inpatient peripheral catheters outside of the intensive care units. Methods: Descriptive analysis and χ2 analysis were done to describe the impact of the peripheral vascular access service. Results: In 2018, 6246 consults were reviewed. Of these, 26% did not require vascular access. Similarly, in 2019, 7861 consults were reviewed, and 35.3% did not require vascular access. Use of central catheters decreased from 21% in 2017 to 17% in 2018 and 2019. Conclusions: The peripheral vascular access service allowed patients to receive appropriate peripheral vascular access devices and avoid unnecessary peripheral catheter placements. This may have preserved patients' peripheral vasculature and thus prevented premature central catheter placement and contributed to an overall decrease in central catheter days. With the peripheral vascular access service, peripheral vascular access devices were selected, placed, and maintained by experts with a standardized process that promoted a culture of quality and patient safety.
      pubtype: Academic Journal
      doctype:
        algorithm
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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