New organizational model to foster good practice. Central venous access management in cancer patients

Issue Central Venous Access positioning is a common practice in cancer patients, however improper devices' management lead to complications and multiple accesses to hospital services, increasing costs. Assessment and certification of Central Venous Access insertion site at hospital so as proper dressing at home, are required; patient empowerment in management of complex technologies is desirable to improve outcomes. Problem Description To tackle the abovementioned issues, PICC project was drawn up in joint action between the Strategic Health and Social care Agency and the Research Institute on Cancer in Puglia. The aim is to pilot an organisational model for central venous access positioning and remote monitoring barely technology driven and based on safe storage of outcomes pictures, patient/care-givers empowerment, integrated care approach. A sistematic review of good practices for Central Venous Access management was conducted in june 2019; besides an analysis of medical devices public procurement procedures was performed at national scale; a survey was edited to probe the existence of diverse organisational models to insert and manage Central Venous Access. Results Very preliminary data are avalaible. Procurement analysis showed: around 15 companies of Central Venous Access and related medical devices' producers; a spread of Central Venous Access location medical devices/supply of services based on few firms (including consumables). The analysis helps to identify the “least common multiple” in technologic equipment to support Central Venous Access management to develop a standard and applicable model, not driven by a conditioning “starting choice” (catheter selection, tip location, dressings). Lessons A standard Central Venous Access management certification procedure can be realized regardless of potential technology driven approach. A Central Venous Access remote monitoring model based on images and empowered patients can allow daily review fostering integrated care. Key messages Patients’ proper training, even in complex technologies usage, can increase self awareness and empowerment and promote compliance to innovative organizational models. Collaboration among patients – caregivers and professionals, set up of a dynamic pictures store to record Central Venous Access management procedures can improve oucomes avoiding added costs.