Universal adhesive vascular access securement with Grip-Lok devices

2020 ◽  
Vol 29 (8) ◽  
pp. S28-S33
Author(s):  
Andrew Barton
Keyword(s):  
Vascular Access ◽  
Best Practice ◽  
Skin Irritation ◽  
Cost Effective ◽  
Universal Adhesive ◽  
Vascular Access Devices ◽  
Access Device ◽  
Vascular Access Device ◽  
Reliable Solution ◽  
Medical Adhesive

The use of sutureless, adhesive securement devices in vascular access has become recommended as best practice, because they are a cost-effective, reliable solution. After a vascular access device has been inserted, catheter securement is one of the most important aspects of care and maintenance. The Grip-Lok® range offers secure, comfortable adhesive securement for all types of vascular access devices. The products use hypoallergenic medical adhesive, which reduces the risk of skin irritation and provides a reliable, adaptable alternative to suturing.

Medical adhesive-related skin injuries associated with vascular access: minimising risk with Appeel Sterile

2020 ◽  
Vol 29 (8) ◽  
pp. S20-S27
Author(s):  
Andrew Barton
Keyword(s):  
Vascular Access ◽  
Care Bundle ◽  
Patient Harm ◽  
Common Procedure ◽  
Vascular Access Devices ◽  
Care Bundles ◽  
Access Device ◽  
Skin Injuries ◽  
Vascular Access Device ◽  
Medical Adhesive

Vascular access device insertion is a common procedure in healthcare, and complications associated with vascular access can be serious and cause considerable patient harm. The use of care bundles to reduce the risks of these complications is well documented. However, the removal of devices, especially those associated with medical adhesive, can cause significant skin injuries, which often could be avoided if this aspect is included in the care bundle and the risk factors are better understood in healthcare. Appeel Sterile is an effective sterile silicone-based medical adhesive remover that is available in a variety of formats. It is the only sterile medical adhesive remover available, which makes it the safest choice for use with vascular access devices.

Vascular access device securement for oncology patients and those with chronic diseases

2021 ◽  
Vol 30 (8) ◽  
pp. S20-S25
Author(s):  
Michelle L Hawes
Keyword(s):  
Chronic Illness ◽  
Chronic Diseases ◽  
Vascular Access ◽  
Skin Irritation ◽  
Activity Level ◽  
Vascular Access Devices ◽  
Access Device ◽  
Line Placement ◽  
Vascular Access Device

This article presents three case studies, each discussing securement issues as they relate to the use of long-term vascular access devices from the perspectives of the clinician and the patient. The choice of securement should be weighed against the patient's activity level, duration of the line placement, infection risks and inevitable skin irritation caused by repeated replacement of adhesive securement. Living with a chronic illness requiring frequent infusions is difficult enough—worrying about the device being dislodged should not be an additional stressor.

scholarly journals International recommendations for a vascular access minimum dataset: a Delphi consensus-building study

2020 ◽  
pp. bmjqs-2020-011274
Author(s):  
Jessica Schults ◽  
Tricia Kleidon ◽  
Vineet Chopra ◽  
Marie Cooke ◽  
Rebecca Paterson ◽  
...  
Keyword(s):  
Vascular Access ◽  
Delphi Study ◽  
Healthcare Professionals ◽  
International Consensus ◽  
Vascular Access Devices ◽  
Response Options ◽  
Access Device ◽  
Vascular Access Device ◽  
Device Use ◽  
Minimum Dataset

BackgroundData regarding vascular access device use and outcomes are limited. In part, this gap reflects the absence of guidance on what variables should be collected to assess patient outcomes. We sought to derive international consensus on a vascular access minimum dataset.MethodsA modified Delphi study with three rounds (two electronic surveys and a face-to-face consensus panel) was conducted involving international vascular access specialists. In Rounds 1 and 2, electronic surveys were distributed to healthcare professionals specialising in vascular access. Survey respondents were asked to rate the importance of variables, feasibility of data collection and acceptability of items, definitions and response options. In Round 3, a purposive expert panel met to review Round 1 and 2 ratings and reach consensus (defined as ≥70% agreement) on the final items to be included in a minimum dataset for vascular access devices.ResultsA total of 64 of 225 interdisciplinary healthcare professionals from 11 countries responded to Round 1 and 2 surveys (response rate of 34% and 29%, respectively). From the original 52 items, 50 items across five domains emerged from the Delphi procedure.Items related to demographic and clinical characteristics (n=5; eg, age), device characteristics (n=5; eg, device type), insertion (n=16; eg, indication), management (n=9; eg, dressing and securement), and complication and removal (n=15, eg, occlusion) were identified as requirements for a minimum dataset to track and evaluate vascular access device use and outcomes.ConclusionWe developed and internally validated a minimum dataset for vascular access device research. This study generated new knowledge to enable healthcare systems to collect relevant, useful and meaningful vascular access data. Use of this standardised approach can help benchmark clinical practice and target improvements worldwide.

A patient’s decision aid for vascular access placement in the emergency department

2019 ◽  
Vol 21 (4) ◽  
pp. 419-425
Author(s):  
Oluseyi Obadeyi ◽  
Nana Baffoe ◽  
James Paxton
Keyword(s):  
Emergency Department ◽  
Vascular Access ◽  
Decision Aid ◽  
Patient Decision Aid ◽  
Vascular Access Devices ◽  
Access Device ◽  
Patient Decision ◽  
Post Test ◽  
Device Placement ◽  
Vascular Access Device

Background: Vascular access device placement is one of the most routinely performed procedures in the emergency department. Despite its high usage, most patients have limited knowledge about vascular access device placement. Patient decision aids have been utilized heavily in non-emergency department settings to provide basic clinical information regarding a patient’s medical care options. In this study, we investigated whether exposure to a patient decision aid on vascular access devices and patients’ experiences with vascular access devices would influence their vascular access device preference during an acute care episode. Methods: Patients in this institutional review board–approved study were enrolled prospectively in the emergency department at a busy level 1 trauma institution. A patient decision aid on vascular access device was constructed using criteria developed by the International Patient Decision Aid Standards. All participants were exposed to the patient decision aid and were asked to complete two questionnaires, and two tests. Results: Fifty subjects (50) were enrolled prospectively in the emergency department. The mean pretest score was 17.2% (95% confidence interval, 0.54–1.18), while the mean post-test score was 72.4% (95% confidence interval, 3.15–4.09). We found that patients who were exposed to the patient decision aid preferred landmark-based peripheral intravenous lines over ultrasound-guided peripheral intravenous lines in this data set. Conclusion: The result from this analysis indicated that most patients visiting the emergency department are not knowledgeable about their options related to vascular access device placement. The observed increase in the average correct responses on the post-test indicates that a patient decision aid can be an effective educational tool in the emergency department.

PICC-PORT totally implantable vascular access device in breast cancer patients undergoing chemotherapy

2019 ◽  
Vol 21 (4) ◽  
pp. 460-466 ◽  
Author(s):  
Sergio Bertoglio ◽  
Ferdinando Cafiero ◽  
Paolo Meszaros ◽  
Emanuela Varaldo ◽  
Eva Blondeaux ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Vascular Access ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Breast Cancer Patients ◽  
Vascular Access Devices ◽  
Access Device ◽  
Vein Thrombosis ◽  
Vascular Access Device

Background and objectives: The increasing use of arm totally implantable vascular access devices for breast cancer patients who require chemotherapy has led to a greater risk of complications and failures and, in particular, to upper extremity deep vein thrombosis. This study aims to investigate the outcomes of the arm peripherally inserted central catheter-PORT technique in breast cancer patients. Methods: The peripherally inserted central catheter-PORT technique is an evolution of the standard arm-totally implantable vascular access device implant based on guided ultrasound venous access in the proximal third of the upper limb with subsequent placement of the reservoir at the middle third of the arm. A prospective study was conducted on 418 adult female breast cancer patients undergoing chemotherapy. The primary study outcome was peripherally inserted central catheter-PORT failure. Results: Median follow-up was 215 days. Complications occurred in 29 patients (6.9%) and failure resulting in removal of the device in 11 patients (2.6%). The main complication we observed was upper extremity deep vein thrombosis, 10 (2.4%); all patients were rescued by anticoagulant treatment without peripherally inserted central catheter-PORT removal. The main reason for removal was reservoir pocket infection: 4 (0.9%) with an infection rate of 0.012 per 1000 catheter days. Cumulative 1-year risk of failure was 3.6% (95% confidence interval, 1.3%–7.1%). With regard to the patients’ characteristics, body mass index <22.5 was the only significant risk for failure ( p = 0.027). Conclusion: The peripherally inserted central catheter-PORT is a safe vascular device for chemotherapy delivery that achieves similar clinical results as traditional long-term vascular access devices (peripherally inserted central catheter and arm totally implantable vascular access device, in particular) in breast cancer patients.

scholarly journals Adverse Events Associated With Midline Vascular Catheters

2020 ◽  
Vol 41 (S1) ◽  
pp. s114-s114
Author(s):  
Richard Hankins ◽  
Nicholas Lambert ◽  
Mark Rupp ◽  
Terry Micheels ◽  
Elizabeth Lyden ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Vascular Access ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Line ◽  
Quality Improvement Initiative ◽  
Vascular Access Devices ◽  
Access Device ◽  
Vein Thrombosis ◽  
Vascular Access Device

Background: Central-line–associated bloodstream infections (CLABSIs) result in increased patient morbidity. Guidelines recommend against peripheral venous catheters when access is required for longer than 6 days, often leading to central venous catheter (CVC) placement. To improve vascular access device choice and reduce the potential risk of CLABSI, we implemented a quality improvement initiative comprised of a vascular access algorithm and introduction of a midline vascular access device (MVAD). We report complications associated with MVAD use including deep vein thrombosis (DVT), thrombophlebitis, and BSI. Methods: A prospective quality improvement assessment from October 2017 through March 2018. All MVADs were monitored for DVT, thrombophlebitis, and BSI. Insertion time and removal of MVAD were tracked, as well as presence of other vascular access devices. Results: From October 2017 through March 2018, 858 MVADs were inserted in 726 different patients, yielding 3,588 MVD days. In total, 6 primary BSIs occurred in patients with MVADs. In patients with only a MVAD, the rate was 0.72 BSI per 1,000 MVAD days, whereas patients with an MVAD as well as a CVC had a rate of 1.98 per 1,000 MVAD days. The overall CLABSI rate at the institution during this period of time was 1.24 per 1,000 CVC days. Also, 29 cases of thrombophlebitis occurred, for a rate of 3.84 per 1,000 catheter days in patients with only an MVAD compared to 4.63 per 1,000 catheter days in patients with an MVAD and a CVC. Also, 25 DVTs occurred during this time, resulting in a rate of 2.88 per 1,000 catheter days in patients with only an MVAD and 4.63 per 1,000 catheter days in patients with multiple vascular-access devices. A significant correlation was noted between MVAD indwell time and BSI (P = .0021) and thrombophlebitis (P = .0041). The median indwell time for patients experiencing BSI was 16.17 days ± 8.04 days, whereas the median indwell time for patients experiencing thrombophlebitis was 9.24 days ± 7.99 days. Conclusions: The implementation of a vascular-access algorithm including MVAD may effectively reduce CVC insertions and BSIs. The rate of BSI in MVAD was below that of CLABSI during the assessment period. Known complications associated with MVAD include DVTs and thrombophlebitis, which correlates with the duration of catheterization, and these risks appear to be further compounded in patients requiring multiple devices for vascular access. Further research into comparing the risk of vascular access of MVAD with CVC is warranted.Funding: NoneDisclosures: None

scholarly journals The state of vascular access teams: results of a European survey

2021 ◽  
Author(s):  
Noemí Cortés Rey ◽  
Fulvio Pinelli ◽  
Fredericus van Loon ◽  
Jennifer Caguioa ◽  
Gema Munoz Mozas ◽  
...  
Keyword(s):  
Vascular Access ◽  
Multidisciplinary Teams ◽  
Access Management ◽  
Public And Private ◽  
Vascular Access Devices ◽  
Access Device ◽  
Systematic Monitoring ◽  
European Health ◽  
Vascular Access Device ◽  
Access Policies

Background: Many European health institutions have appointed multidisciplinary teams for the general management of vascular access to help improve efficiency, patient safety and reduce costs. Vascular access teams (VATs), or infusion teams, are specifically trained groups of healthcare professionals who assess, place, manage and monitor various outcomes and aspects of vascular access care. Objective: To assess the current landscape of vascular access management as a discipline across Europe. Methods: A Faculty of European VAT leads and experts developed a survey of 20 questions which was disseminated across several European countries. Questions focused on respondent and institution profile, vascular access device selection and placement, monitoring and reporting of complications, and access to training and education. The 1449 respondents included physicians, nurses, anaesthetists, radiologists and surgeons from public and private institutions ranging in size. Results: Availability of dedicated VATs vary by country, institution size, and institution type. Institutions with a VAT are more likely to utilise a tool (e.g., algorithm or guideline) to determine the appropriate vascular access device (55% vs 38%, p < 0.0002) and to have feedback on systematic monitoring of complications (40% vs 28%, p = 0.015). Respondents from institutions with a VAT are more likely to have received training on vascular access management (79% vs 53%, p < 0.0001) and indicated that the VAT was a source of support when difficulties arise. Conclusion: The survey results highlight some of the potential benefits of implementing a dedicated VAT including use of a broader range of vascular access devices, increased awareness of the presence of vascular access policies, increased likelihood of recent vascular access training, and increased rates of systematic monitoring of associated complications. The study reveals potential areas for further focus in the field of vascular access care, specifically examining the direct impact of vascular access teams.

Implications for maintaining vascular access device patency and performance: Application of science to practice

2019 ◽  
Vol 20 (5) ◽  
pp. 461-470
Author(s):  
Alexandra Hawthorn ◽  
Andrew C Bulmer ◽  
Sapha Mosawy ◽  
Samantha Keogh
Keyword(s):  
Fluid Dynamics ◽  
Vascular Access ◽  
Current Knowledge ◽  
Biological Fluid ◽  
Evidence Base ◽  
Clinical Practices ◽  
Vascular Access Devices ◽  
Access Device ◽  
Vascular Access Device ◽  
And Performance

Introduction:Vascular access devices are commonly inserted devices that facilitate the administration of fluids and drugs, as well as blood sampling. Despite their common use in clinical settings, these devices are prone to occlusion and failure, requiring replacement and exposing the patient to ongoing discomfort/pain, local vessel inflammation and risk of infection. A range of insertion and maintenance strategies are employed to optimize device performance; however, the evidence base for many of these mechanisms is limited and the mechanisms contributing to the failure of these devices are largely unknown.Aims/objectives:(1) To revisit existing understanding of blood, vessel physiology and biological fluid dynamics; (2) develop an understanding of the implications that different clinical practices have on vessel health, and (3) apply these understandings to vascular access device research and practice.Method:Narrative review of biomedical and bioengineering studies related to vascular access practice.Results/outcomes:Current vascular access device insertion and maintenance practice and policy are variable with limited clinical evidence to support the theoretical assumptions underpinning these regimens. This review demonstrates the physiological response to vascular access device insertion, flushing and infusion on the vein, blood components and blood flow. These appear to be associated with changes in intravascular fluid dynamics. Variable forces are at play that impact blood componentry and the endothelium. These may explain the mechanisms contributing to vascular access failure.Conclusion:This review provides an update to our current knowledge and understanding of vascular physiology and the hemodynamic response, challenging some previously held assumptions regarding vascular access device maintenance, which require further investigation.

scholarly journals Predictors of adverse outcomes using a multidimensional nursing assessment in an Italian community hospital

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249630
Author(s):  
Beatrice Gasperini ◽  
Gilda Pelusi ◽  
Annamaria Frascati ◽  
Donatella Sarti ◽  
Franco Dolcini ◽  
...  
Keyword(s):  
Vascular Access ◽  
Community Hospital ◽  
Patient Characteristics ◽  
Nursing Assessment ◽  
Vascular Access Devices ◽  
Acute Hospitalization ◽  
Access Device ◽  
Risk Of Death ◽  
Increased Risk ◽  
Vascular Access Device

Background There is growing evidence about the role of nurses in patient outcomes in several healthcare settings. However, there is still a lack of evidence about the transitional care setting. We aimed to assess the association between patient characteristics identified in a multidimensional nursing assessment and outcomes of mortality and acute hospitalization during community hospital stay. Methods A retrospective observational study was performed on patients consecutively admitted to a community hospital (CH) in Loreto (Ancona, Italy) between January 1st, 2018 and May 31st, 2019. The nursing assessment included sociodemographic characteristics, functional status, risk of falls (Conley Score) and pressure damage (Norton scale), nursing diagnoses, presence of pressure sores, feeding tubes, urinary catheters or vascular access devices and comorbidities. Two logistic regression models were developed to assess the association between patient characteristics identified in a multidimensional nursing assessment and outcomes of mortality and acute hospitalization during CH stay. Results We analyzed data from 298 patients. The mean age was 83 ± 9.9 years; 60.4% (n = 180) were female. The overall mean length of stay was 42.8 ± 36 days (32 ± 32 days for patients who died and 33.9 ± 35 days for patients who had an acute hospitalization, respectively). An acute hospitalization was reported for 13.4% (n = 40) of patients and 21.8% (n = 65) died. An increased risk of death was related to female sex (OR 2.25, 95% CI 1.10–4.62), higher Conley Score (OR 1.19; 95% CI 1.03–1.37) and having a vascular access device (OR 3.64, 95% CI 1.82–7.27). A higher Norton score was associated with a decreased risk of death (OR 0.71, 95% CI 0.62–0.81). The risk for acute hospitalization was correlated with younger age (OR 0.94, 95% CI 0.91–0.97), having a vascular access device (OR 2.33, 95% CI 1.02–5.36), impaired walking (OR 2.50, 95% CI 1.03–6.06) and it is inversely correlated with a higher Conley score (OR 0.84, 95% CI 0.77–0.98). Conclusion Using a multidimensional nursing assessment enables identification of risk of nearness of end of life and acute hospitalization to target care and treatment. The present study adds further knowledge on this topic and confirms the importance of nursing assessment to evaluate the risk of patients’ adverse outcome development.

An overview of some needleless IV systems designed for use in conjunction with vascular access devices

2004 ◽  
Vol 9 (1) ◽  
pp. 39-40
Author(s):  
Kelli Rosenthal ◽  
William H. Hirsch
Keyword(s):  
Vascular Access ◽  
Vascular Access Devices ◽  
Access Device ◽  
Advantages And Disadvantages ◽  
Vascular Access Device

Abstract Needleless systems prevent accidental needlesticks by eliminating sharps from the field and yet providing access to the indwelling vascular access device. The advantages and disadvantages of the three groups of needleless systems, blunt cannula devices, luer-activated devices, and pressure activated safety valves, are discussed.

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