Evidence-based Practice: Improving Outcomes for Patients with a Central Venous Access Device

2011 ◽  
Vol 16 (2) ◽  
pp. 64-72 ◽  
Author(s):  
Dorothy Mathers
Keyword(s):  
Health Care ◽  
Continuing Education ◽  
Best Practice ◽  
Evidence Based Practice ◽  
Central Venous Access ◽  
Relevant Literature ◽  
Venous Access ◽  
Positive Pressure ◽  
Evidence Based ◽  
Central Venous

AbstractPurpose: To apply evidence-based practice when flushing central venous access devices (CVADs).Background/Introduction: There is a lack of standardized flushing protocols for CVADs among health care institutions. Identifying best practice and assuring skillful implementation of evidence-based practice protocols is essential to maintaining catheter patency.Review of Relevant Literature: Evidence supports the use of nonheparinized saline flush, positive-pressure valve caps, and proper flushing technique to maintain CVAD patency (Bowers, Speroni, Jones, & Atherton, 2008; Hadaway, 2006; & Jasinsky & Wurster, 2009). Reinforcement of proper flushing techniques has demonstrated improved patency rates of CVADs (Feehery, Allen, & Bey, 2003).Methods: Corporate and individual in-services were conducted to improve nurses' skill and knowledge of evidence-based practice related to flushing CVADs. Outcomes were measured by comparing baseline data with data collected in the same manner post-education. Data was obtained by means of a questionnaire and direct observation of nurses' flushing technique.Outcomes: The evidence-based practice project demonstrated a significant improvement (p <0.05) in both the nurses' knowledge and skill in flushing CVADs.Conclusion: Continuing education and reinforcement of proper flushing technique is an appropriate strategy to increase knowledge of and compliance with evidence-based practice protocols.Implications for practice: Providing continuing education and periodic reinforcement of nursing skills can lead to improved patient outcomes. These strategies, along with changing flushing protocols to non-heparinized saline, can also reduce health care costs. Future studies are needed to determine the appropriate frequency of in-service education.

Tele-ICU Partners Enhance Evidence-Based Practice

2012 ◽  
Vol 23 (3) ◽  
pp. 312-322 ◽  
Author(s):  
Carol Olff ◽  
Cynthia Clark-Wadkins
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Best Practice ◽  
Evidence Based Practice ◽  
Care Delivery ◽  
Health Care Team ◽  
Evidence Based ◽  
New Members ◽  
Management Protocol ◽  
Information Research

Evidence-based practice (EBP) has become more than just a trendy buzzword in health care; EBP validates care delivery methods and grants satisfaction to nurses in knowing the care they provide is based on valid, current information. Research-based enhancements are paramount to the advancement of nursing practice and prompt the implementation of creative methods to improve care. The advent of the tele–intensive care unit (ICU) introduces new members of the health care team to assist with implementation of EBP initiatives. This new partnership results in improved length of stay, mortality rates, and ventilator times for critical care patients. Current literature suggests that a clinician-driven, standardized ventilator management protocol is of significant benefit. Tele-ICU clinicians provide an interactive element to coordinate interdisciplinary team efforts. Enhanced communication, data evaluation, and timely intervention expedite the weaning process and reduce ventilator length of stay. Consistent collaboration between tele-ICU and bedside clinicians successfully improves patient outcomes through standardized adherence to best-practice initiatives.

scholarly journals US-guided peripheral vascular interventions, comments on the EFSUMB guidelines

2016 ◽  
Vol 18 (2) ◽  
pp. 231 ◽  
Author(s):  
Christoph Frank Dietrich ◽  
Rudolf Horn ◽  
Susanne Morf ◽  
Liliana Chiorean ◽  
Yi Dong ◽  
...  
Keyword(s):  
Central Venous Access ◽  
Venous Access ◽  
Point Of View ◽  
European Federation ◽  
Evidence Based ◽  
Interventional Ultrasound ◽  
Peripheral Vascular ◽  
Central Venous ◽  
Complication Risk ◽  
General Aspects

Peripheral venous as well as arterial punctures have traditionally been performed on the basis of designated anatomi- cal landmarks. However, due to patients’ individual anatomy and vessel pathology and depending on individual operators’ skill, this landmark approach is associated with a signi cant failure rate and complication risk. This review comments on the evidence-based recommendations on ultrasound (US)-guided vascular access which have been published recently within the framework of Guidelines on Interventional Ultrasound (INVUS) of the European Federation of Societies for US in Medicine and Biology (EFSUMB) from a clinical practice point of view. Part 1 of the review had its focus on general aspects of US- guidance and on central venous access, whereas part 2 refers to peripheral vascular access.US-guided peripheral vascular interventions, comments on the EFSUMB guidelines

Evidence‐Based Strategies and Recommendations for Preservation of Central Venous Access in Children

2019 ◽  
Vol 43 (5) ◽  
pp. 591-614 ◽  
Author(s):  
Kevin M. Baskin ◽  
Leonard A. Mermel ◽  
Theodore F. Saad ◽  
Janna M. Journeycake ◽  
Carrie M. Schaefer ◽  
...  
Keyword(s):  
Central Venous Access ◽  
Venous Access ◽  
Evidence Based ◽  
Central Venous

scholarly journals Managing central venous access during a health care crisis

2020 ◽  
Vol 72 (4) ◽  
pp. 1184-1195.e3
Author(s):  
Tristen T. Chun ◽  
Dejah R. Judelson ◽  
David Rigberg ◽  
Peter F. Lawrence ◽  
Robert Cuff ◽  
...  
Keyword(s):  
Health Care ◽  
Central Venous Access ◽  
Venous Access ◽  
Central Venous ◽  
Health Care Crisis

scholarly journals Epicutaneo-caval catheters in neonates: New insights and new suggestions from the recent literature

2019 ◽  
Vol 21 (6) ◽  
pp. 805-809 ◽  
Author(s):  
Giovanni Barone ◽  
Mauro Pittiruti
Keyword(s):  
Neonatal Intensive Care ◽  
Recent Literature ◽  
Central Venous Access ◽  
Daily Practice ◽  
Venous Access ◽  
Neonatal Intensive Care Units ◽  
Evidence Based ◽  
Central Venous ◽  
Vascular Access Devices ◽  
Venous Access Devices

Epicutaneo-caval catheters have been widely used in neonatal intensive care units since Shaw has described them in 1973. These central venous access devices are usually placed at bedside and they have the purpose of delivering parenteral nutrition and/or drugs that are not compatible with the peripheral route. Even though in the last decade there was a fast advancement in the world of vascular access devices, such changes have only marginally affected the field of neonatal venous access. The aim of this editorial is to give 10 recommendations that correspond to 10 novelties in the field of epicutaneo-caval catheter: some are already evidence-based and should be introduced in our daily practice now, while others are particularly interesting and deserve further clinical studies.

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