Intravascular Quarterly | IQ | Aug/Sept 2021 by Association for Vascular Access

The e-news publication of the Association for Vascular Access AUGUST/SEPTEMBER 2021 | VOLUME XI | ISSUE 3

Intravascular

QUARTERLY

Global Disclaimer: The views and opinions expressed in the Intervascular Quarterly Newsletter are those of the authors and do not necessarily reflect the official policies or positions of the Association for Vascular Access (AVA) or any of its leaders, volunteers, employees, committees, networks or other groups associated with AVA. For information on this publication, please email info@avainfo.org.

Protect Patients • Educate Clinicians • Save Lines

IN THIS ISSUE Page 2

Inside AVA: Notes from the Executive Team

Page 4

Board Development Committee Update

Page 4

Sick of IV Restarts/Lineus Medical advertisement

Page 6

The Use of Tissue Adhesive for Peripheral Intravenous and Arterial Catheters: A Survey of Clinician Experience

Page 10

JAVA Reviewer Update

Page 11

Allergic to Newbie IVs

Page 12

Special Section Insert – AVASM21 Virtual

Page 20

UltraDrape/Parker advertisement

Page 21

Quality Improvement Initiative: Maximizing Dressing Adherence to Minimize Infections

Page 24

Editorial Piece: PICCPerfect

Page 27

AVA 2021 Virtual Meeting

Page 28

Thank You Industry Partners

Page 30

Network News

Page 31

ISAVE That Podcast

Page 32

AVA Academy

Page 33

ISAVE That Line

Page 34

Have You Been Listening? ISAVE That Podcast

Page 35

Welcome to Our Newest AVA Members

1 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER

INSIDE AVA:

NOTES FROM THE EXECUTIVE TEAM Cate Brennan, MBA, CAE | Chief Executive Officer and Tonya Hutchison, CAE | Chief Operations Officer

This column allows the AVA Executive Team to keep you up to date on new member benefits on the horizon, our educational activities, AVA programs, services, advocacy, and other issues of interest. AVA is your professional home, and we always want to hear from you on how we can improve our services. Please email at cbrennan@avainfo.org and thutchison@avainfo.org.

COVID-19 and the Delta variant continue to have a significant impact on our vascular access specialists, the healthcare industry, and AVA. The entire globe continues to struggle with infection and vaccination rates, and now, sadly, among children too young to be vaccinated. On Aug. 10, the AVA Board of Directors made the difficult decision to make AVASM21 completely virtual. Here is the statement:

equally grateful to each of you for your dedication to AVA. We welcome your thoughts and ideas on how to improve today, tomorrow and the future.

AVA ANNOUNCES NEW GROUP MEMBERSHIP CAMPAIGN In July, AVA staff announced the new CARES by AVA membership campaign. CARES stands for Competency, Action, Results, Education, Satisfaction. The overall goal of CARES is to improve the vascular

AVA BOARD STATEMENT ON COVID-19 In consideration of current events related to COVID-19 and the safety of attendees, exhibitors, speakers, staff and other external partners, the AVA Board of Directors has made the difficult decision to change the face-to-face scientific meeting, set to be in Orlando, FL, to a completely virtual event. Our conference planning staff is now pivoting to expand the current virtual event and ensure the delivery of high-quality, impactful continuing education and networking for all stakeholders. The event date will remain September 16-19, 2021. Complete information will be coming within the next week about event details and how to transfer your in-person registration to virtual or cancel. Please watch your email and the AVA website for updates as they become available. Sincerely, Jocelyn Hill, AVA Board President on behalf of the AVA Board of Directors But despite the uncertainty of an ever-changing landscape, AVA continues to move ahead with developing valuable, innovative programs and services for both members and non-members. We are deeply thankful for the enormous amount of time, creativity, and leadership of our Board of Directors and volunteers; they do AVA’s important work while simultaneously juggling stressful “real” jobs. We are

access (VA) knowledge of all types of healthcare providers who provide VA services in hospitals, outpatient clinics, infusion clinics, mobile clinical teams, and home settings. Specifically, AVA’s goal is to diversify the types of healthcare professions within the AVA membership, CONTINUED ON NEXT PAGE AUGUST / SEPTEMBER 2021 2

INSIDE AVA, CONTINUED FROM PREVIOUS PAGE including providers who are not part of a VA specialty team. In short, this is a national discount membership program for AVA networks and employer groups. Nurses are a critical part of the VA community and AVA continues to embrace their special role. With networks, the specific goal is to reach 80 percent of common membership. The campaign will pilot fourth quarter of 2021 to as a direct campaign to large-employer settings as well as to AVA Networks and industry partners. The marketing will target hospital-based leaders, including Chief Nursing Officers, Chief Medical Officers, Directors of Professional Development, and Clinical Nurse Education Specialists.

AVA NETWORKS In July, AVA held a special meeting for network leaders under the title Growing Together. The network representatives and AVA staff discussed how to strengthen their partnerships to attract and provide added value to members and nonmembers. To meet is original and current mission, AVA national is increasing its focus to diversify its members and include more multidisciplinary members. Other discussions included how to work together to deliver continuing education hours for virtual events and how to streamline administrative tasks for the networks. Up to 66 percent of AVA networks expressed an interest in AVA acting as their management company. AVA staff is developing a comprehensive management services package that may include billing, dues collection, event registration/payment, member database services, website hosting/ management, marketing events/membership and general communications. More details will be available in the next IQ. AVA on the Road, a new program for industry partners, is offered to networks. This traveling webinar allows industry partners to rebroadcast a previously presented webinar at a net-work meeting. Please contact avainfo@avainfo.org for more information.

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IYCMI → The Board of Directors recently established two new membership categories: Faculty and International. International dues are as follows (in US dollars): High Income Country, $125; Medium Income Country, $35; and Low Income Country, $20. For faculty and students not participating in the Fundamental curriculum project, AVA dues are reduced to $100 for faculty and $75 for students. Please visit www.avainfo.org for more information. → AVA has established formal alliances with the Infusion Nurses Association, the Canadian Vascular Access Association, and the Asociación de Terapia de Infusión y Seguridad del Paciente (Argentina). → AVA works in partnership with Infusion Knowledge to provide clinicians the VA-BC™ Exam Preparation Webinar Study Bundle twice a year. Please tell your colleagues. For general information, please email avaed@avainfo.org.

AVA FOUNDATION The AVA Foundation welcomed Michelle (Mickey) L. Hawes, DNP, RN, CRNI, VA-BCTM as a new board member in July. Hawes is a research consultant for Data to Wisdom Research Consulting, based in Indiana. She has been an active volunteer with AVA, INS and other organizations. She has published in JAVA and Journal of Infusion Nursing.

VAF SCHOLARSHIPS AND GRANTS The AVA Foundation provides grants to healthcare practitioners for both specialized continuing education and pre- and post-licensure academic education with a focus on vascular access. These grants encourage grantees to deliver the highest level of vascular access care to patients. The AVA Foundation supports seminars, panels and education programs that disseminate research and provide updates on trends and innovation in vascular access practice and that stimulate learning and innovation.

BOARD DEVELOPMENT COMMITTEE Kristin Jacobs, DNP, MSN, RN, VA-BC™ | BDC Chair

The Board Development Committee (BDC) has been hard at work vetting and recruiting new AVA Board members and the new 2022-23 AVA Board was announced on August 31st.

Treasurer: Jon Bell, RN, MSN, VA-BC™

The BDC is responsible for (1) developing and recommending a slate of officers and Directors at Large (DL) to AVA Board, (2) reviewing candidates for AVA Foundation Board positions, and (3) filling open BDC positions. Applicants are reviewed for how they can expand AVA’s mission and strategic plan. These factors were used to guide the BDC in our candidate selection. The Board Development Committee recommended a slate of candidates to the current AVA Board, and they were approved in July. Now it is time for the AVA membership to vote on the slate!

Directors-at-Large: Staci Harrison, DNP, RN Swapna Kakani, MPH Nieltje Gedney, BA Karen Laforet, RN, MCISc-AHCP, CCHN, CVAA, VA-BC™ Nael Mhaissen, MD Chaitenya Razdan, MBA

THE 2022 AVA BOARD OF DIRECTORS President: Tonja Stevens, RN, BSN, VA-BC™ President-Elect: Tonya Heim, MHA, MSN, RN, NEA-BC Presidential Advisor: Jocelyn Grecia Hill, MN, RN, VA-BC™, CVAA

Secretary: Michelle DeVries, MPH, CIC, VA-BC™

The BDC also worked diligently to reconstruct the application processes this year. The BDC began vetting new 2022 BDC candidates in mid-2021, announcing the slate to be voted on at the beginning of August. Voting was open to active AVA members for three weeks in August and the new Board was announced late that month. If you are interested in interviewing with the BDC for future Board positions, please keep an eye out for a call for applicants in 2022. Applicants must provide one reference which can be from someone you have worked with previously but cannot be an AVA employee, current CONTINUED ON NEXT PAGE AUGUST / SEPTEMBER 2021 4

BOARD DEVELOPMENT COMMITTEE, CONTINUED FROM PREVIOUS PAGE AVA Board, AVA Foundation Board, VACC Board, or BDC member. If you have any questions about the slate or how to become more active in AVA, please contact Tonya Hutchison, AVA COO, at thutchison@avainfo.org.

PRESIDENT-ELECT

TREASURER

Tonya Heim, MHA, MSN, RN, NEA-BC

Jon Bell, MSN, RN, VA-BCTM

SECRETARY

DIRECTOR AT LARGE

Michelle DeVries, MPH, CIC, VA-BCTM

Nieltje Gedney, BA

DIRECTOR AT LARGE

Karen Laforet, RN, MCISc-AHCP, CCHN(c), CVAA(c), VA-BCTM

Chaitenya Razdan, MBA

2021 BOARD OF DIRECTORS PRESIDENT

SECRETARY

JOCELYN GRECIA HILL, MN, RN, CVAA(C), VA-BC™

RUSSELL NASSOF, JD

PRESIDENT-ELECT

JON BELL, RN, MSN, VA-BC™

TONJA STEVENS, RN, VA-BC™

PRESIDENTIAL ADVISOR

LORI KACZMAREK, MSN, RN, VA-BC™

TREASURER

DIRECTOR-AT-LARGE

MONTE HARVILL, MD

DIRECTOR-AT-LARGE

TONYA HEIM, MHA, MSN, RN, NEA-BC DIRECTOR-AT-LARGE

STACI HARRISON, DNP, RN DIRECTOR-AT-LARGE

SWAPNA KAKANI, MPH

CHELLIE (MICHELLE) DEVRIES, MPH, CIC, VA-BC™

DIRECTOR-AT-LARGE

CHIEF EXECUTIVE OFFICER

MARKETING MANAGER & ANALYTICS DIRECTOR

CLINICAL EDUCATION SPECIALIST

cbrennan@avainfo.org

kmaisel@avainfo.org

NAEL MHAISSEN, MD

AVA STAFF CATE BRENNAN, MBA, CAE

KAYCE A. MAISEL

CHIEF OPERATIONS OFFICER

TONYA HUTCHISON, CAE thutchison@avainfo.org

5 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER

BLAKE HOTCHKISS, BSN, RN, CCRN, CRNI, VA-BC™ bhotchkiss@avainfo.org

DIRECTOR OF CLINICAL EDUCATION

JUDY THOMPSON, MSNEd., RN, VA-BC™ jthompson@avainfo.org

THE USE OF TISSUE ADHESIVE FOR PERIPHERAL INTRAVENOUS AND ARTERIAL CATHETERS:

A SURVEY OF CLINICIAN EXPERIENCE Lori Kaczmarek, MSN, RN, VA-BC™ | Vascular Access Clinical Specialist, Adhezion Biomedical, LLC

INTRODUCTION Recent editions of Intravascular Quarterly (IQ) included reports about the clinician experience and patient outcomes using tissue adhesive (TA) in the neonatal population and another described TA use to manage post device insertion bleeding and oozing in adults. 1, 2 This report seeks to understand the impact of TA on peripheral intravenous (PIV) and arterial catheters (AC).

PERIPHERAL AND ARTERIAL CATHETER FAILURE Attention to the care and management of peripheral intravenous (PIV) catheters has grown over the past several years. Organizations like Emergency Care Research Institute (ECRI), Association for Vascular Access (AVA) and Infusion Nurses Society (INS) have raised awareness about vascular access complications, failure rates and the need for better clinical education. They also serve to educate consumers and improve their understanding about the risk these devices pose. 3-6 Helm, Steere, Jones, and others have contributed to the body of knowledge about PIV failure, along with the human and economic impact. 7-12 By contrast, fewer studies exist about arterial catheters (AC), their associated complications, and failure rates. Arterial catheters, however, are known to contribute to bloodstream infections (BSI) and also fail in the same manner other vascular access devices do. 13, 14 In fact, Timsit et al., report that AC BSI is similar to that observed with central venous catheters (CVC) prompting the call to employ similar prevention bundles for care and maintenance for AC’s. 15

There is growing momentum to disclose all hospital onset bacteremia (HOB) over central line associated bloodstream infection (CLABSI) as a quality indicator for public reporting in the United States (US). 16, 17 This change would certainly draw more attention to PIV and AC care and maintenance. Pay-for performance initiatives have, after all, been effective in reducing CVC CLABSI by 50% from 2008 to 2014.18 The true impact of the pandemic on CLABSI rates has yet to be appreciated, but early reporting suggests an increase in catheter-associated bacteremia. 19

INNOVATIVE TECHNOLOGY In 2019, Dr. Robert Helm provided a classic article update to “Accepted but Unacceptable: Peripheral IV Failure”. In it, he affirms that more awareness exists about the problem of PIV failure since his 2015 report, yet the problem remains unsolved.

While clinical experts and industry are striving to make improvements, the impact of trauma and contamination are fundamental components of PIV care that must be improved. The “simple transparent dressing is inadequate to fully stabilize and secure” our catheters, said Helm. Perhaps the most noteworthy statement in this article relates to the CONTINUED ON NEXT PAGE AUGUST / SEPTEMBER 2021 6

USE OF TISSUE ADHESIVE, CONTINUED FROM PREVIOUS PAGE need to “…introduce catheter care and management practices in a way that is clinically simple, highly reproducible, and cost-effective.” 8 This is where TA comes in: an innovative technology which is simple, highly reproducible and is cost-effective. The only TA approved and labeled for vascular access use is SecurePortIV® (Adhezion Biomedical, LLC, Wyomissing, PA, USA). SecurePortIV® (SPIV) is a highly purified medical cyanoacrylate (CA) approved for all vascular access devices and comes with no age limits. 20 In vitro testing of polyurethane and silicone to assess long-term exposure of tissue adhesive on catheters found no chemico-physical changes. 21

SURVEY DEMOGRAPHICS A questionnaire sent to twelve (12) clinicians was completed in June 2021. The inquiry targeted a cross-section of hospitals that use TA for care and maintenance of vascular access devices including AC and PIV catheters. The hospitals surveyed include 11 within the United States (US) and 1 from Qatar (QA). The responses represent adult, pediatric, and/or neonatal inpatient populations. Fifty percent (50%) report using TA on both PIV and AC’s.

PERIPHERAL INTRAVENOUS CATHETERS (PIV) Prior to using TA on PIV catheters, respondents report a variety of securement methods in use. The majority (55%) report no additional infection prevention modalities in use. Some (27%) use CHG gel dressings and others (18%) apply a CHG disk. Fifty percent (50%) use TA on all PIV catheters regardless of who inserts them while others add TA to the PIV based 7 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER

on clinical judgement, ultrasound guided PIVs, or a Vascular Access Team (VAT) member may apply.

ARTERIAL CATHETERS (AC)

Care and maintenance of ACs prior to implementing TA was widely variable among the clinicians’ responses: • “They are sutured and then secured with a CHG impregnated dressing.” • “Sterile insertion, CHG disk, sutured.” • “Integrated securement device and clear occlusive dressing.” • “Same as venous (PIV) catheters.” • “Adhesive tape, CHG disk, transparent dressing.” • “Just a simple PIV dressing with tape for securement (this is what the Certified Registered Nurse Anesthetists [CRNA] used. Our VAT would use an adhesive securement device under the CHG dressing.” Like PIV catheters, it is equally distributed as to who applies TA to ACs and when. Forty-three percent (43%) report applying TA on all AC’s and the same report only those ACs placed by a designated team. Fourteen (14%) apply TA to ACs based on clinical judgement.

TA IMPACT ON PIV AND AC CARE AND MAINTENANCE When asked to summarize the impact TA has made on PIV and AC care and maintenance in their CONTINUED ON NEXT PAGE

USE OF TISSUE ADHESIVE, CONTINUED FROM PREVIOUS PAGE organization, clinicians shared this feedback: • “Reduced line migration” (PIV and AC) • “We simply glue the insertion site and eliminate sutures and CHG disk.” (AC) • “My team uses it in all types of access. We provide vascular access services to all areas [including] NICU where you may find a 300gm patient to our oncology, cardiac and pediatric intensive care. The team feels strongly about using it in all various lines the team places and helps with. Lines include PICC’s, Midlines, EDC, USGPIVs, arterial lines, tunnel and non-tunnel lines.” (PIV and AC)”

• “Catheter is no longer pistoning, maintaining the best waveform to monitor the patient.” (AC) • “Decreased the number of dressing changes and catheter manipulation that could contribute to early failure.” (AC and PIV) • “Once applied correctly the lines do not re-bleed causing dressing adherence issues.” (AC) • “This product provided two important functions for PIVs. It seals the insertion site and stabilizes the device. Sealing the site can reduce the risk of tissue and blood stream infections. Stabilizing the device can reduce movement that contributes to phlebitis and can help reduce accidental removals.” (PIV) • “We are so satisfied with this products ability to anchor the site and reduce bleeding, infection, and loss of site. The overall patients appreciate it, so our satisfaction levels are up.” (PIV) • “Our CVOR and Cath lab team absolutely praise this product.” (PIV) • “Once I brought this product to our Infection Prevention team it was immediately approved

for purchase. There is no question we all need to use this product, when I explain to the patient the reason for its use, they get excited and are happy to know we use the most up to date products protecting them from infection. Our ICU physicians LOVE this product as well.” (SPIV)

SUMMARY The changing healthcare landscape demands attention on all vascular access device care and management, beyond central lines. When considering options for VAD care and management, heed the words of Dr. Helm, “…simple, highly reproducible and cost-effective.” 8 TA has demonstrated positive outcomes across all ages and devices and is simple to use. Innovative technology like this allows organizations to simplify care and maintenance across the spectrum of VADs and among all caregivers. Finally, streamlining care gives clinicians the opportunity to maintain a high level of competency regardless of the device they are caring for.

SUMMARY 1.

Kaczmarek L. Tissue Adhesive Bleeding and Oozing Practice Summary. Intravascular Quarterly. 2021;XI(2):9-13. Accessed May 15, 2021. https://issuu.com/avainfo/docs/published_-_iq_-_ may_2021

Kaczmarek L. A survey of clinicians: Bringing tissue adhesive to the neonatal population. Intravascular Quarterly. 2021;XI(1):2-5. Accessed Feb 20, 2021. https://cdn.ymaws.com/www.avainfo.org/ resource/resmgr/images/iq/iq_-_february_2021-final.pdf

Association for Vascular Access (AVA). Resource Guide for Vascular Access: Recommended Study Guide for Vascular Access Board Certification. vol 3. 2019:148.

ECRI Institute. Top 10 Patient Safety Concerns for 2019: Executive Brief. 2019. Accessed March 15, 2019. https://www.ecri.org/ landing-top-10-patient-safety-concerns-2019

2021 Infusion Therapy Standards of Practice Updates. J Infus Nurs. Jul-Aug 01 2021;44(4):189-190. doi:10.1097/ NAN.0000000000000436

ECRI Institute. Top 10 Patient Safety Concerns for 2021: Executive Brief. 2021. https://www.ecri.org/

Carr PJ, Rippey JCR, Cooke ML, et al. Derivation of a clinical decisionmaking aid to improve the insertion of clinically indicated peripheral intravenous catheters and promote vessel health preservation. An observational study. PLoS One. 2019;14(3):e0213923. doi:10.1371/ journal.pone.0213923

Helm RE. Accepted but Unacceptable: Peripheral IV Catheter Failure: 2019 Follow-up. J Infus Nurs. May/Jun 2019;42(3):149150. doi:10.1097/NAN.0000000000000324

CONTINUED ON NEXT PAGE AUGUST / SEPTEMBER 2021 8

CORE VALUES RESPECT AVA believes treating others with respect will ensure a safe and healthy environment.

ACCOUNTABILITY AVA believes in setting and meeting timely deadlines and working together with our members, volunteers and other partners to pursue outcomes that help patients.

INTEGRITY AVA aspires to have a foundation of honesty and integrity in everything we do.

TEAMWORK AVA believes working together to unleash everyone’s potential will achieve exceptional results.

EXCELLENCE AVA creates a lasting and positive impact within vascular access through excellence in all endeavors.

MISSION

To lead healthcare by protecting patients and providers to improve lives

VISION

USE OF TISSUE ADHESIVE, CONTINUED FROM PREVIOUS PAGE 9.

Helm RE, Klausner JD, Klemperer JD, Flint LM, Huang E. Accepted but unacceptable: peripheral IV catheter failure. J Infus Nurs. MayJun 2015;38(3):189-203. doi:10.1097/NAN.0000000000000100

10. Jones RK. Short Peripheral Catheter Quality and Economics: The Intravenous Quotient. J Infus Nurs. Nov/Dec 2018;41(6):365-371. doi:10.1097/NAN.0000000000000303 11. Pires ABM, Lima AFC. Direct cost of peripheral catheterization by nurses. Rev Bras Enferm. Jan-Feb 2019;72(1):88-94. doi:10.1590/0034-7167-2018-0250 12. Steere L, Ficara C, Davis M, Moureau N. Reaching One Peripheral Intravenous Catheter (PIVC) Per Patient Visit With Lean Multimodal Strategy: the PIV5Rights™ Bundle. Journal of the Association for Vascular Access. 2019;24(3):31-43. doi:10.2309/j. java.2019.003.004 13. Greer MR, Carney S, McPheeters RA, Aguiniga P, Rubio S, Lee J. Radial Arterial Lines Have a Higher Failure Rate than Femoral. West J Emerg Med. Mar 2018;19(2):364-371. doi:10.5811/ westjem.2017.11.34727 14. O’Horo JC, Maki DG, Krupp AE, Safdar N. Arterial catheters as a source of bloodstream infection: a systematic review and metaanalysis. Crit Care Med. Jun 2014;42(6):1334-9. doi:10.1097/ CCM.0000000000000166 15. Timsit JF, Ruppe E, Barbier F, Tabah A, Bassetti M. Bloodstream infections in critically ill patients: an expert statement. Intensive Care Med. Feb 2020;46(2):266-284. doi:10.1007/s00134-020-059506

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A world with safe vascular access

16. Rock C, Thom KA, Harris AD, et al. A Multicenter Longitudinal Study of Hospital-Onset Bacteremia: Time for a New Quality Outcome Measure? Infect Control Hosp Epidemiol. Feb 2016;37(2):143-8. doi:10.1017/ice.2015.261 17. Dantes RB, Abbo LM, Anderson D, et al. Hospital epidemiologists’ and infection preventionists’ opinions regarding hospital-onset bacteremia and fungemia as a potential healthcare-associated infection metric. Infect Control Hosp Epidemiol. May 2019;40(5):536540. doi:10.1017/ice.2019.40 18. Centers for Disease Control and Prevention website. National and state healthcare associated infections progress report. Published 2016. Accessed July 06, 2021, https://www.cdc.gov/hai/pdfs/ progress-report/hai-progress-report.pdf 19. Fakih MG, Bufalino A, Sturm L, et al. COVID-19 Pandemic, CLABSI, and CAUTI: The Urgent Need to Refocus on Hardwiring Prevention Efforts. Infect Control Hosp Epidemiol. Feb 19 2021:122. doi:10.1017/ice.2021.70 20. Adhezion Biomedical LLC. SecurePortIV: Indication for Use (IFU). SPI-IFU01-1903. June 2019. Accessed April 14, 2021. www. SPIVTraining.com 21. Di Puccio F, Giacomarro D, Mattei L, Pittiruti M, Scoppettuolo G. Experimental study on the chemico-physical interaction between a two-component cyanoacrylate glue and the material of PICCs. J Vasc Access. Jan 2018;19(1):58-62. doi:10.5301/jva.5000816

JAVA REVIEWER UPDATE JAVA Editorial Team

Additionally, the Editorial Team is currently working on a project to update the JAVA reviewers list and contact information.

When a manuscript is received, it is matched by the classification to quickly identify content experts who are best qualified to provide a review. Without at least one content area identified, it often becomes time-consuming to identify reviewers. This can delay the progress of the manuscript through the review process. Unfortunately, this field is not set as a “required” field in the system and, as a result, many reviewers did not identify any classifications. Please note that you may identify additional areas of expertise using the “Edit Personal Keywords” tab.

If you are identified as a REVIEWER in the JAVA editorial manager system we ask that you take a moment to log in, review, and update your information in the system. Please check that everything correct including your current email address.

Thank you for updating your information and identifying your area of expertise. If you are no longer available as a JAVA reviewer, kindly email javaeditor@avainfo.org to be removed from the volunteer pool.

Then, please review, update, and select one or more “Areas of Expertise” in the personal classification system, as seen here.

We would appreciate it if you would update your profile no later than September 30, 2021. If you need assistance with the editorial manager you may submit a request at peertracksupport@ allenpress.com or email the JAVA Editorial Team at javaeditor@avainfo.org

If you are an AVA member with a passion for editing or publishing, The Journal of Vascular Access needs you! Many hands make light work – and help meet publishing deadlines! This is a great opportunity for anyone who would like to volunteer with AVA. If you are interested in becoming a JAVA reviewer, please submit your details on the AVA website here: https://www.avainfo.org/page/ JAVAReviewer

AUGUST / SEPTEMBER 2021 10

ALLERGIC TO NEWBIE IVs – HEREDITARY HEMORRHAGIC TELANGIECTASIA Angelique Gaston BSN RN VA-BC™ | Saint Joseph Mercy Health System

Many patients we care for every day as vascular access specialists should be wearing medical alert bracelets declaring “Allergic to Newbie IVs.” Sometimes we can get to the patients before multiple attempts are made to achieve vascular access, sometimes we can’t. Even when we are there to intervene, convincing the attending physician that our opinion is based on science and experience can be difficult. The first step is to alert the staff that the patient is a hard stick, then have the VAT support the patient during catheter placement from assessment to device securement. A 30-year-old obese female entered an emergency department (ED) after coughing blood from her tracheostomy. The patient was alert and oriented x 4, speaks in complete sentences, is married, and lives at home with her family. There were multiple attempts by the ED staff to obtain a peripheral vascular access device (PVAD) that were unsuccessful. As a result, the vascular access team (VAT) was called to assess. Arriving to the ED, the VAT scanned the chart and reviewed the patient’s history. This patient was well known to the VAT because of her fragile vascular system. During previous visits, the patient had multiple PVADs that would only last hours for mysterious reasons. With further investigation, the specialist discovered that the patient had Hereditary Hemorrhagic Telangiectasia (HHT), also referred to as Olser-Weber-Rendu syndrome. This syndrome is a rare autosomal dominant vascular disorder that often leads to excessive bleeding. The condition causes the development of arteriovenous malformations (AVMs). Common problems associated with this vascular disorder 11 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER

include epistaxis, gastrointestinal bleeding, and iron deficiency. In addition, the brain, lungs, and liver are frequently affected in patients with HHT. The VAT advocated for this patient to receive a central vascular access device (CVAD) as the initial vascular access. The ED physician was initially resistant until she received the facts about the patient’s history from a vascular access specialist’s perspective. The patient would be admitted to the intensive care unit and continued to cough up large quantities of blood through her trach. Despite the information on vascular fragility and superior vena cava syndrome history, the ED physician had an intern prepared to place the CVAD. The VAT requested that the physician attempt the femoral placement instead of a novice. At this point, the patient advocated for herself and asked: “Can the most experienced person in the room place the line.” The physician then instructed the resident to place the CVAD in the left femoral area. The resident struggled with the initial stick to reach the deep vessel using real-time ultrasound but eventually implanted the line successfully. CONTINUED ON PAGE 20

AVASM21 WELCOME TO AVASM21

Current AVA Board President, Jocelyn Hill, welcomes attendees to the conference.

SPECIAL EDITION

Celbrating the upcoming virtual Annual Scientific Meeting of the AVA.

SEPTEMBER 2021

KNOW BEFORE YOU CLICK Everything you need to know to have a wonderful conference!

SCHEDULE AT A GLANCE Plan your virtual attendance to earn as many CEs as possible!

IN HONOR OF THE UPCOMING ANNUAL SCIENTIFIC MEETING OF THE ASSOCIATION FOR VASCULAR ACCESS, WE HAVE PUT TOGETHER THIS SPECIAL IQ INSERT TO CELEBRATE AVA’S BIGGEST EVENT!

Follow #AVASM21 on social media:

AVA@AVAINFO.ORG - WWW.AVAINFO.ORG/ANNUAL - 877-924-AVA1

SPECIAL INSERT FOR AVASM21 VIRTUAL

Know Before You Click Everything you need to know to have a happy, stress-free conference!

We know joining virtual meetings can be a drag - technology glitches, slow internet, the works. In order to help attendees prepare for the “trip,” we’ve collected everything you may need to know in one convenient place!

SSEE P TT.. 1166 -- 11 99,, 02 2 11 22 0 Special Schedule

Continuing Education

On-Demand Content

Table of Contents Know Before You Click

Welcome to AVASM21 Virtual

Sponsor & Exbhibitors for AVASM21 Virtual

AVA Foundation Recognizes AVASM21 Scholarship Winners

Digital Poster List

Schedule-at-a-Glance

TECHNICAL REQUIREMENTS, CONTINUING EDUCATION, APP DOWNLOAD, LOGIN INSTRUCTIONS, SCAN-AND-WIN, AND MORE!

JOCELYN HILL WELCOMES ATTENDEES

JOIN US IN THANKING OUR GENEROUS SPONSORS AND EXHIBITORS

ALSO ANNOUNCED: THE TEXT-TO-WIN DONATION CAMPAIGN

LIST OF CURRENTLY PUBLISHED POSTERS FOR THE VIRTUAL CONFERENCE, AVAILABLE ONLINE AND IN THE APP.

THANK YOU FOR READING OUR SPECIAL INSERT FOR AVASM21 VIRTUAL. CHECK OUT THE SCHEDULE AT A GLANCE AND GET READY TO JOIN!

The first and most important tip to having an excellent AVASM21 is to test your equipment. Wifi can flounder and VPNs can easily block access, so we suggest that attendees run a quick system check, which we’ve included on the front page of the event website here. The second most important thing to remember is that only Google Chrome and Mozilla Firefox browswers are supported. Other browswers may not allow access to live sessions or on-demand content. Please be sure to login to the website and/ or AVA Meetings app ahead of time on the equipment you will use during the meeting to ensure everything works smoothly. Last, we ask you to add a picture and attendee ribbons to bring some fun and normalcy. Can’t wait to see you all soon!

Click the image below to download your PDF copy.

SPECIAL INSERT FOR AVASM21 VIRTUAL

Welcome to AVASM21 Virtual I am filled with anticipation and excitement as we prepare for the 2021 AVA Virtual Scientific Meeting to begin. While the AVA Board of Directors and I didn’t think the meeting would be provided virtually again this year—well… here we are. In mid-August and only five short weeks before this meeting, the board made the very difficult decision to go from our original plan of a hybrid format—meaning both in-person with some virtual – and pivot to virtual-only. With the ongoing challenges of COVID-19 and the variants surfacing, we decided that your health and safety came first. The situation in Florida and other southern states in the U.S. made the board consider its ethical responsibility. We simply did not want to place any or additional stress on the health care system and on our colleagues.

[WE] DIDN’T THINK THE MEETING WOULD BE PROVIDED VIRTUALLY AGAIN THIS YEAR— WELL… HERE WE ARE. [BELOW] JOCELYN GRECIA HILL MN, RN, CVAA(C), VA-BC™, 2021 PRESIDENT OF THE ASSOCIATION FOR VASCULAR ACCESS AND BOARD LIAISON TO THE AVA FOUNDATION

As disappointing as it is to not see each other again this year, the AVA Virtual Scientific Meeting is still something to celebrate. I want to acknowledge and thank the D-Team, the amazing, dedicated and hard-working committee of volunteers who made this meeting happen. This group worked earlier this year to line-up the best speakers and presentations. Then, they did it again to ensure the program worked in this virtual format on very short notice. Thank you Jeanine Morehead, D-Team Chair for leading the group. Our thanks go to the speakers who have pivoted along with us to meet the tight timelines so that their work can still be

“I want to acknowledge and thank the D-Team. This group worked earlier this year to line-up the best speakers and presentations. Then, they did it again to ensure the program worked in this virtual format on very short notice. Thank you!”

“We are grateful for the loyal support of our many industry partners, exhibitors, and sponsors supporting this meeting and who continue to provide valuable support.” showcased and shared. We are grateful for the loyal support of our many industry partners, exhibitors and sponsors supporting this meeting and who continue to provide valuable support. And of course, I want to thank our MIGHTY AVA staff and Conference Managers who have worked tirelessly under great pressure to deliver this quality, virtual meeting! I want to thank YOU all –nearly 700 people at last count – for virtually attending. You are the power of this meeting and are what AVA is about at its core. Your commitment to providing the best vascular access (VA) care and your passion for patient safety makes AVA’s mission “to lead healthcare by protecting patients and providers and to improve lives” a reality.

constant state of change—and changes continue to accelerate in our world of healthcare. So please consider how you can help AVA grow and adapt to our future. We are always looking for volunteers! You can volunteer for committees or work groups, or writing an article for our journal, the Journal for the Association for Vascular Access (JAVA). We want to diversify and grow our membership. A deep dive looking at our mix of clinicians shows we need more physicians, advanced practice providers, respiratory therapist and others. In order to improve the delivery of safe and effective VA services, we need people from the different disciplines speaking the same VA-related language. You can help by educating your colleagues and peers about the unique education and networking opportunities. Please invite someone to attend an AVA network meeting or tune in to one of AVA’s many online webinars and podcasts. Let’s ensure AVA is not a “best-kept secret.”

You are the power of this meeting and what AVA is about at its core

Our AVA community is strong and healthy. The AVA Board and I continue to focus on the future and culture of AVA and, along with our fiduciary and other duties, we concentrate on our duty of foresight. This is a challenge because we are in a

The AVA Foundation (AVAF) continues to thrive, and we have worked hard to strengthen our partnership. There are many great opportunities ahead and AVA and AVAF President Amy Bardin-Spencer will speak to this important collaboration and work later in the week. Also later in the week, we will hear from President-Elect Tonja Stevens and CEO Cate Brennan about additional insight to future initiatives, projects and the work being done in the background. I am fortunate to have these two strong leaders to work with as we aim to make AVA better and stronger. In closing, thank you for all you

have done during this unprecedented, crazy time – we are sure to look back with pride (and maybe pure exhaustion, too) at how we learned to appreciate the critical importance of looking forward and trying to anticipate and react to change. I look forward to seeing everyone IN PERSON soon and catching up on news and accomplishments that we can share and celebrate. Enjoy the 2021 AVA Virtual Scientific Meeting and make sure to check back frequently to network with your peers and make new friends. Thank you.

SPECIAL INSERT FOR AVASM21 VIRTUAL

Thank you to our Sponsors & Exhibitors PREMIUM 3M Medical Solutions BD PATRON Access Vascular B. Braun Medical Inc. CONTRIBUTOR Adhezion Biomedical, LLC Interrad Medical - SecurAcath Lineus Medical

EXHIBITORS AccuVein Inc AngioDynamics Assocation for Vascular Access (AVA) AVA Foundation British Journal of Nursing Canadian Vascular Access Association (CVAA) CIVCO Medical Solutions Eloquest Healthcare, Inc. Entrotech LIfe Sciences PrevahexCHX Ethicon Infection Risk Management

Fujifilm Sonosite Grand Canyon University Gus Gear Healthcare Hygiene Magazine I.V. House, Inc Kurin Inc Magnolia Medical Technologies

Oley Foundation Parker Laboratories, Inc. PDI pfm medical, inc. PICC Excellence, Inc. PICC Guard

Premium

Patron

Contributor

Sheathing Technologies, Inc. Starboard Medical StatSeal (Biolife, LLC) Teleflex Theragenics/Galt Medical Vascular Access Certification Corporation (VACC)

SPECIAL INSERT FOR AVASM21 VIRTUAL

AVA Foundation Recognizes AVASM21 Virtual Scholarship

Pictured below, from top to bottom: Amy Mulgrew, RN, CRNI, IgCN, VA-BC™ Diana M. Dowdall BSN, RNC, IgCN Shaila Green, BSN, RN, VA-BC™

It is the charitable (501(c)(3)) arm of the Association for Vascular Access (AVA), which advances the vascular access specialty and defines its standards through evidence-based interventions to enhance healthcare and patient outcomes. For more information, visit www.avainfo.org.

IF YOU WOULD LIKE TO MAKE A ONE-TIME DONATION, OR SCHEDULE REGULAR DONATIONS TO SUPPORT THE MISSION OF THE FOUNDATION, PLEASE FOLLOW THE “TEXT TO DONATE” INSTRUCTIONS ON THE RIGHT HAND SIDEBAR.

THE ASSOCIATION FOR VASCULAR ACCESS FOUNDATION Board of Directors announced three scholarship winners for the AVASM21 Virtual conference. The scholarship pays for one full registration to the virtual meeting and complimentary access to all education sessions through Nov. 15. Scholarship winners can earn up to 27 accredited hours that can be used towards certification and recertification for the VA-BCTM (Vascular Access Board Certified) credential. “WE SERVE CLINICIANS interested in vascular access, students of healthcare professions as well as vascular access patients and their families,” said Foundation President Amy Bardin-Spencer, Ed.D., MSc, RRT, VA-BC™. “The Foundation does this through providing education scholarships, practice innovation, research, and patient and provider advocacy.”

The scholarship winners are: Amy Mulgrew, RN, CRNI, IgCN, VA-BC™; Diana M. Dowdall BSN, RNC, IgCN; and Shaila Green, BSN, RN, VA-BC™. AMY MULGREW is a nurse educator at Advanced Infusion Care. She said her goal is to “provide the most up-to-date educational information to our remote nursing team. We have over 100 Infusion nurses in the U.S.” DIANA DOWDALL is a corporate nurse care manager for Upstate HomeCare, which covers the entire upstate region of New York. She said, “Being able to attend this conference will allow me to continue to provide the best education and guidance to all clinical staff at Upstate HomeCare as well as assure competencies within our nursing staff utilizing the most up to date guidelines for inserting and maintaining vascular access lines.” SHAILA GREEN is a vascular access nurse at Children’s Health Hospital in Dallas, TX. She said that attending the conference will allow her to learn from people from a wide range of backgrounds. “The focused nature of learning at a conference will give me a chance

to dig deeper and understand different topics that will allow me to open my mind to new ways of doing things.” “OUR SCHOLARSHIP WINNERS and other attendees bring AVA great ideas on new products and services to help them in their practice,” said Cate Brennan, chief executive officer of AVA Foundation and AVA. “We hope that through this exposure to the Foundation they will continue to champion patient and provider advocacy through research and volunteerism.” The scholarships were partially funded by an educational grant from 3M corporation. Applicants provide their resume or curriculum vitae, letters of recommendation and a completed application form. The applicants are reviewed and selected by the Foundation board of directors. THE AVA FOUNDATION is dedicated to saving lives through vascular access innovation, research and education. It serves as clinicians interested in vascular access, students in the healthcare professions and vascular access patients and their families. It is the charitable (501(c)(3)) arm of the Association for Vascular Access (AVA), which advances the

Take 5, Give $5 Text AVAF5 to 44321 to donate to the AVA Foundation DONATIONS OF $5 OR MORE DURING WILL BE ENTERED TO WIN A $50 AMAZON GIFT CARD.

vascular access specialty and defines its standards through evidence-based interventions to enhance healthcare and patient outcomes. For more information, visit www.avainfo.org. The AVA Foundation is dedicated to saving lives through vascular access innovation, research and education. It serves as clinicians interested in vascular access, students in the healthcare professions and vascular access patients and their families.

SPECIAL INSERT FOR AVASM21 VIRTUAL

Digital Posters at AVASM21 Virtual This year, AVA will feature digital posters hosted on the AVA Meetings app and the event Website, available now. Log in to the platform to view high-quality images of the posters on your device and connect with the authors! Jason Battle The impact of disinfecting caps on healthcare-associated infections during COVID-19 Kendra Bendak Tissue Adhesive Trial and Implementation to Mitigate Catheter Migration Kendra Bendak Viscosity of Contrast Determines Required Max Flow Rate Robert Buzas Prevent Occlusion Complications so you can Treat the Patient: A Comparative Study of Anti-Reflux Technology in the Home Infusion Setting Evelyn Chan Virtual reality for pediatric peripheral intravenous cannulation pain: A randomized controlled trial Gwendolyn Coney Access Device Outcomes in a Skilled Nursing Facility - A Retrospective Chart Review Tara Daly Impacting Neonatal Patient Care: Reducing Needle Sticks, with an Extended Dwell Catheter Amy Deimel Effect of the Implementation of a Standardized Ultrasound

Guided Peripheral Intravenous Catheter Course on Peripheral Intravenous Catheter Complication Incidence and Dwell Times Mini Dominic Successful Implementation of the Midline Program by Critical Care Nurses Elizangela dos Santos The use of the Peripherally Inserted Central Catheter at a Brazilian teaching hospital Juan Estupinan Vascular Access in Nutritional Support Program: Experience High Complexity Hospital in Colombia Juan Estupinan Prospective Observational Multicenter study in COVID-19 Patients Using an Antimicrobial and Antithrombogenic PICC: Latin America Experience Juan Estupinan Is Antimicrobial and Antithrombogenic PICC Catheter Safe and Effective? Latin America Experience Patrick Evangelista When the dressing is compromised… how well does the securement device stabilize?

Melissa Gallo Vascular Access: A Navigation Map Robert Garcia Stressing the Dressing: The role of antimicrobial dressings in the prevention of CRBSIs Nisha Gupta Comparative Performance Evaluation of Central Venous Catheters with Two Different Antimicrobial Technologies Nisha Gupta Antimicrobial Effectiveness of Chlorhexidine-Treated Peripherally Inserted Central Catheter after Trimming DeeAnn Hebrink Supportive Care for Children with Autism Spectrum Disorder (ASD) during Venipuncture Maggie horn Evaluation of the use of near-infrared vein visualization technology in a community hospital: A valued-added clinical experience Stephanie Horn Implementation of Pediatric Subcutaneous Rehydration Standard of Practice for Difficult Intravenous Access Patients

Stephanie Horn Implementation of a Pediatric Vascular Access Program to Improve Outcome Metrics Joshua Hughey Preventing the cascade of complications from blood reflux: Comparison of needleless connectors with and without anti-reflux technology Emelia Hutto Evaluation of the Efficacy of the AccuVein AV500 During Lymphovenous Bypass (LVB) Surgery: A Feasibility Pilot Rebecca Kanaley Evaluation of the Difficult Intravenous Access (DIVA) Soring in Hospitalized Pediatric Patients Carrie Kollar Optimizing the Effectiveness of Short Peripheral Intravenous Catheters Victor Lange Decreased Specimen Contamination and Hemolysis Through the Use of a Novel Universal Blood Collection Device

SPECIAL INSERT FOR AVASM21 VIRTUAL

Log into the website at www. avainfo.org/annual or open the app on your mobile device to view all of the AVASM21 digital posters in detail.

Maria Lozano Preservation of Vessel Health with the Use of Midline Catheters for Red Blood Cell Exchange

Scan with your phone camera to download the app

Cheryl McBeth Staff Engagement and Clinical Practice Changes: Implementation of an Alcohol/Chlorhexidine Swab for CLABSI Prevention and Scrub the Hub Compliance Marie Moss Using ‘Just-In-Time’ Communication Strategies to Confirm Indications for Central Lines in Order to Achieve and Sustain Low CLABSI Rates in a New York City Hospital Adult ICU Before and After the COVID Epidemic Nancy Moureau Cost-effectiveness of ANTT®-approved Secure Barrier & Dressing (UltraDrape™) for UGPIV Insertions Guadalupe Ordaz Nielsen Leveraging Digital Patient Education to Impact Vascular Access Device Readmission Rates Brittany PechousUtilization of Vascular Access Glue to Improve Integrity of Pediatric PICC Line Dressings

Erica Shadle Quality Improvement Through the Veins of Collaboration and Education: The Implementation of a Division-Based Vascular Liaison Model EB Stapp Midline catheter use in the neonatal intensive care unit Lauren Stone An Innovative Approach to Hospital-Wide Peripheral Intravenous Infiltration & Extravasation (PIVIE) Education during a Pandemic Dena Todd Utilizing Near-InfraRed (NIR) technology to reduce costs associated with Peripheral IntraVenous (PIV) access Kelly Walker Improving Patient Care and Promoting Vascular Access Expertise by Transforming from a Traditional IV Team to an Enhanced Vascular Access Team Shellie Wood Stop the Confusion! Clarifying Central Venous Access Devices in a Tertiary Pediatric Healthcare System

Theresa Petroff CLABSI Reduction: A Culture of Always Matheus Rens Closed intravenous systems for central vascular access: a difference maker for CLABSI rates in neonates? Leticia Riley “Failed Peripheral IntraVenous Catheter Placement Leads to Inappropriate Peripheral Inserted Central Catheters use and Patient Harm: A Retrospective Database Analysis”

Thank you for reading -- join us on the 16th! Break to Visit Resource Center

SCHEDULE AT-A-GLANCE DAY 2

DAY 1

Thursday, Sept. 16

Friday, Sept. 17

DAY 3

DAY 4

Saturday, Sept. 18

Sunday, Sept. 19

8 AM

9 AM

10 AM

11 AM

12 PM

1 PM

8 AM Welcome & Opening Remarks 8:45 AM - 9 AM

9 AM

Live Session / Live Q&A with Speaker(s) 9 AM - 10:15 AM

Break to Visit Resource Center

Break

Live Session / Live Q&A with Speaker(s) 10:30 AM - 11:45 AM

Break to Visit Resource Center

Break

Live Session / Live Q&A with Speaker(s) 12 PM - 1:15 PM

Live Session / Live Q&A with Speaker(s) 12 PM - 1:15 PM Exhibitor Product Roundtable 1:15 PM - 2:45 PM

Exhibitor Symposia LIVE Q&A 1:30 PM - 2:30 PM

Break Live Session / Live Q&A with Speaker(s) 11 AM - 12:15 PM

Break

Break to Visit Resource Center

2 PM

Live Session / Live Q&A with Speaker(s) 9 AM - 10:45 AM

Live Session / Live Q&A with speaker(s) 12:30 PM Exhibitor Product - 1:45 PM Roundtable 1:15 PM 2:45 PM

Break to Visit Resource Center

3 PM

4 PM

5 PM

Live Session / Live Q&A with Speaker(s) 2:45 PM - 4 PM

Live Session / Live Q&A with Speaker(s) 2:45 PM - 4 PM Break to Visit Resource Center

Live Session / Live Q&A with Speaker(s) 2:45 PM - 4 PM

Break Live Session / Live Q&A with Speaker(s) 4:15 PM - 5:45 PM

Live Session / Live Q&A with Speaker(s) 4:15 PM - 5:45 PM

Live Session / Live Q&A with Speaker(s) 9 AM - 10:15 AM

Break to Visit Resource Center

Live Session / Live Q&A with Speaker(s) 10:30 AM - 11:45 AM

Live Session / Live Q&A with Speaker(s) 10:30 AM - 12:15 AM

Break to Visit Exhibitor Resource Center, Play Scan & Win, and Enter Exhibitor Giveaways 1:15 PM - 2:45 PM Live Session / Live Q&A with Speaker(s) 2:45 PM - 4 PM

Break to Visit Resource Center Live Session / Live Q&A with Speaker(s)

1 PM

12:30 PM - 1:45 PM

Break to Visit Resource Center

2 PM

Live Session / Live Q&A with Speaker(s) 2 PM - 3:15 PM

3 PM

Break to Visit Resource Center

Live Session / Live Q&A with Speaker(s) 4:15 PM - 5:30 PM

11 AM

12 PM

Break to Visit Resource Center Live Session / Live Q&A with Speaker(s) 12 PM - 1:15 PM

10 AM

Live Session / Live Q&A with Speaker(s) 4:15 PM - 5:45 PM

Live Session / Live Q&A with Speaker(s) 3:30 PM - 4:45 PM Closing Remarks 4:45 PM - 5 PM

4 PM

5 PM

6 PM

Break to Visit Resource Center

6 PM

7 PM

Live Session / Live Q&A with Speaker(s) 6 PM - 7:15 PM

7 PM

8 PM

Opening or Closing Remarks

Exhibitor Symposia or Product Roundtable

Break to Visit Exhibitor Resource Center, Play Scan & Win, and Enter Exhibitor Giveaways

Live Session / Live Q&A with Speaker(s)

Pediatric Neonatal SIG Track Live Session / Live Q&A with Speaker(s)

Subject to change. Check www.avainfo.org for current schedule.

CLICK HERE to register today

END OF SPECIAL ADVERTISING SECTION

Thank you for reading our special advertising section with everything you need to know to join us for this year’s AVASM21. We hope you’re excited as we are to hear from the leaders in vascular access, companies on the cutting edge of innovation, and to network with your colleagues in the field. Click the button to register or direct to the event website to review the schedule and plan your virtual event.

WWW.AVAINFO.ORG/ANNUAL

ALLERGIC TO NEWBIE, CONTINUED FROM PREVIOUS PAGE Now that the CVAD was successfully placed, the securement of the line was equally important. At this facility, a subcutaneous anchor securement system (SASS, i.e., SecurAcath) was employed and remained in place for the life of the line. Due to her history with multiple CVADs, the patient was familiar with the SASS and had many lines successfully secured with this anchoring device. Short of tattooing or placing a medical alert bracelet on every patient with difficult access, our facility chose to alert the staff by placing that information in the allergy section of the electronic medical record. A note in the allergy section is appropriate because, in many cases, a patient with difficult vascular access is a more significant medical issue than a rash that erupts with over-the-counter medication. Consider that even with the VAT standing by directing the right line at the right time, the ED physician initially chose a novice physician to place the femoral CVAD. Then, placement of a left femoral CVAD was completed by a resident with a SASS to secure the line. Every decision made for this patient’s vascular access requirements, from assessment to securement, was equally vital to her successfully receiving the care she needed. The first step is to alert the healthcare professional of a patient in need of the vascular access team as soon as possible. The last step is to lock down that precious line with a SASS.

20 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER

QUALITY IMPROVEMENT INITIATIVE: MAXIMIZING DRESSING ADHERENCE TO MINIMIZE INFECTIONS Lee Steere, RN, CRNI, VA-BC™ | Unit Leader, IV Therapy Services, Hartford Hospital

INTRODUCTION Like all hospitals, our organization is continually focused on optimizing the Institute for Healthcare Improvement’s Triple Aim in order to improve patient care, improve quality and reduce healthcare costs. One way to do this is by minimizing infections, particularly catheter-related bloodstream infections (CRBSIs), as these hospital-acquired infections result in longer hospital stays, increased mortality and significantly higher costs. While no single solution can prevent infections alone, numerous studies show that VAD dressing disruptions are a major risk factor for CRBSIs.1 Evidence-based guidelines from organizations like the U.S. Centers for Disease Control (CDC) and Infusion Nurses Society (INS) recognize the importance of vascular access device (VAD) dressing integrity in minimizing infection risks. The recent paradigm shift from routine to clinically indicated catheter replacement has further increased the importance of protecting insertion sites and making all VADs -- from central to peripheral intravenous (PIV) line -- remain in place longer. Unfortunately, data reveal that dressing disruptions happen far too frequently. We suspected this was the case at Hartford Hospital. Our IV Therapy Services team conducted a trial to test the impact of a gum mastic liquid adhesive on central venous catheter (CVC) dressing integrity. The marked improvement in dressing adherence led to a hospital-wide quality improvement initiative for all central lines to minimize infection risks, improve patient safety and reduce healthcare costs.

DRESSING INTEGRITY IS ESSENTIAL Proper dressing adherence is an essential part of catheter site care and maintenance. Intact dressings prevent complications like catheter migration, dislodgement and infiltration.

Most importantly, preserving dressing integrity can reduce the risk of CRBSIs. According to a 2012 study, the risk of infection increased more than 3-fold after the second dressing disruption, and increased 12fold if the final dressing was disrupted.1 Current guidelines from the INS and CDC define an “unplanned dressing change” as any change that happens within the first seven days -- yet research indicates that dressing disruptions happen with alarming frequency. In 2016, a study of four commercially available CVC dressings showed that the dressings had surprisingly limited durability, with the average dressing change happening every 50 hours -- far less than the recommended seven days. Only three percent of the dressings lasted the full seven days, and 75 percent lasted less than 48 hours.2 Through rounding, our IV therapy team observed that our dressing integrity was less than satisfactory, but we needed to conduct a point prevalence assessment to quantify this. Another hospital within our system, the Hospital of Central Connecticut, had experienced improved dressing adherence with the use of a gum mastic liquid adhesive. In 2019, we began to consider this product as a potential solution that could minimize the dressing disruptions that were putting our patients at risk.

EVIDENCE-BASED LIQUID ADHESIVE Widely used in operating rooms since 1965, the safety and efficacy of gum mastic liquid adhesive is well-documented. It is clinically proven to enhance the adhesive power of a variety of tapes and dressings, performing better than tincture of benzoin or no pretreatment at all.3,4 The non-water soluble, latex-free adhesive is shown to be well-tolerated with a low risk of adverse reactions.4 More recently, as researchers began to explore the use of gum mastic liquid adhesive in vascular access, they found that it provides effective securement and CONTINUED ON NEXT PAGE AUGUST / SEPTEMBER 2021 21

QUALITY IMPROVEMENT INITIATIVE, CONTINUED FROM PREVIOUS PAGE improves dressing integrity from current standards of care. A 2019 study of more than 30,000 dressings applied with gum mastic reported that 96 percent were fully intact upon direct observation.5 Another study showed that impaired peripherally inserted central catheter (PICC) dressings decreased by 67 percent and impaired intrajugular (IJ) dressings by 92 percent.6 This is particularly impressive considering that IJs are used in a notoriously challenging anatomical location.

adherence and the benefits of gum mastic liquid adhesive for improving dressing integrity. While previous standards address the importance of securement, there were no specific recommendations for evidence-based best practices. In the most recent update, INS specifically recommends evaluating the benefits of gum mastic liquid adhesive in order to ensure dressings remain intact, as well as using audit and feedback to implement protocol changes in VAD dressing care and maintenance.10

The adhesive’s durability in moist or moisture-prone areas ensures secure placement over an extended period of time, reducing the likelihood of dressing displacement or device dislodgement. Studies have linked the benefits of this lasting occlusive barrier to a reduction in central line associated blood stream infection (CLABSI) rates. Browne et al. reported that use of gum mastic completely eliminated CVC dressing disruptions and reduced CLABSI rates by 76 percent.7 Another facility reported a decrease in CLABSI rates after adding gum mastic to all central line dressing change kits.8

DRASTIC IMPROVEMENTS FROM CARDIAC ICU TO HOSPITAL-WIDE

Gum mastic is also compatible with chlorhexidine (CHG), which was a major factor in our selection.9 Both CHG skin preparation and CHG-impregnated dressings are an important part of Hartford Hospital’s infection control practices, as numerous organizations recommend these measures to reduce infection risks. We liked that the gum mastic could enhance adhesion of the CHG-impregnated dressings without diminishing the efficacy of the antimicrobial agent. In the 2021 Infusion Therapy Standards of Practice, INS recognizes both the importance of VAD dressing

With such a strong body of evidence, we wanted to see if improving our dressing integrity with gum mastic liquid adhesive could help us minimize infection risks and protect our patients. In November 2019, we initiated a trial to measure its impact on central line dressings in the cardiac intensive care unit (ICU). We began with four days of observational data collection that included bedside rounding VAD site assessments to note the state of the dressings. We categorized “non-intact dressings” in three ways -- edges lifted, partially detached or completely detached. The assessment confirmed our anecdotal observations of suboptimal dressing adherence, as 77 percent of dressings were non-intact. After two four days we saw a adherence.

weeks of staff training and another of post-implementation observation, marked improvement in our dressing We reduced the incidence of dressing disruptions to just 36 percent, with zero dressings either partially or completely detached. In addition, the staff were very enthusiastic about the product. Prior to implementation, IJ dressings required almost daily changes; with the gum mastic liquid adhesive, a majority of IJ dressings lasted the full seven days. It also became clear that these clinical benefits would translate to cost savings CONTINUED ON NEXT PAGE

22 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER

QUALITY IMPROVEMENT INITIATIVE, CONTINUED FROM PREVIOUS PAGE for our institution. This includes minimizing the direct costs associated with premature dressing changes or failed lines due to catheter dislodgement. Soft cost savings include less nursing time spent on unplanned dressing changes, as well as a reduction in excess costs and decreased reimbursement associated with CRBSIs. With concrete evidence of the clinical and economic benefits, the administration quickly approved a hospital-wide quality initiative for use of the gum mastic liquid adhesive with all central lines. Though COVID-19 delayed getting into our CVC kits by a year due to manufacturing delays, the adhesive was added to all CVC Dressing Change Kits by March 2021 and is now being used in all acute care facilities affiliated with Hartford Healthcare. When we conducted a whole-house audit to confirm staff compliance, we saw continued improvements in our dressing adherence rates. Of the 126 VAD sites assessed, 79 percent of dressings were fully intact, compared to just 24 percent in the initial trial.

NEXT STEPS - IMPROVING PIV DRESSING INTEGRITY While gum mastic liquid adhesive is now standard of care for central line dressings at Hartford Hospital, we continue to use it on an as-needed basis for PIV dressings. However, we are developing the protocol for a randomized controlled clinical trial to quantify the impact of the liquid adhesive on PIV dressing integrity. If the results are similar to what we observed with central line dressings, it may eventually become standard of care for PIV catheter securement as well. This research is particularly timely given the recent recommendations from the patient safety organization, ECRI. They included peripheral vascular harm on its list of Top 10 Patient Safety Concerns of 2021.11 PIVs are the most commonly used invasive device in hospitals, but with a failure rate of 35-50 percent, this seemingly routine procedure is putting patients at risk of serious complications.

In order to address PIV harm at an organizational level, they recommend obtaining data from in-depth schedule dressing assessments, as well as using proven technology to facilitate proper catheter securement -- much like we’ve done with central lines at Hartford Hospital. With the shift to value-based care models, all healthcare organizations are searching for ways to reduce infections while providing better outcomes, higher quality and lower healthcare costs. Our experience has shown that using gum mastic liquid adhesive to improve dressing adherence is a simple and effective strategy to achieve that.

REFERENCES 1.

Timsit JF, Bouadma L, et al. Dressing disruption is a major risk factor for catheter-related infections. Crit Care Med. 2012 Jun; 40(6): 1707-14. doi:10.1097/CCM.0b013e31824e0d46.

Richardson A, Melling A, Straughan C. Central venous catheter 2015; 16: 256-61. dressing durability: an evaluation.

Patel N, Smith CE, et al. The influence of tape type and of skin preparation on the force required to dislodge angiocatheters. Can J Anaesth. 1994 Aug; 41(8): 738-41. PMID: 7923524.

Lesesne CB. The postoperative use of wound adhesives. Gum mastic versus benzoin, USP. J Dermatol Surg Oncol. 1992 Nov; 18(11): 990. PMID:1430556.

DeVries M, Sarbenoff J, et al. Improving Vascular Access Dressing Integrity in the Acute Care Setting, Journal of Wound, Ostomy and Continence Nursing: June 28, 2021 - Volume Publish Ahead of Print - Issue - doi: 10.1097/WON.0000000000000787

Pullen D. Quality Improvement Initiative to Improve Dressing Adherence Reveals Improved Dressing Adherence Observations on a Before-After Analysis. Poster presented at: AVA Annual Scientific Meeting, September 7-10, 2014.

Browne B, Moffo H. Quality improvement initiative results in fewer dressing disruptions and improved adherence to best practices. Poster presented at: Greater Cincinnati AACN Trends in Critical Care. April 8, 2016.

Bortz A, Hardinger K, Peltzer J. Impact of implementing Mastisol® in central line dressing changes on central line-associated bloodstream infections in progressive care units: a quality improvement project. Presented at: Magnetizing KC Symposium, February 24, 2015.

Ryder M, Duley C. Evaluation of compatibility of gum mastic liquid adhesive and liquid adhesive remover with an alcoholic chlorhexidine skin preparation. Infus Nurs. 2017; 40(4): 245-252.

10. Gorski, LA, Hadaway, L, Hagle, ME, et al. Infusion Therapy Standards of Practice. 8TH J Infus Nurs. Revised 2021. 11. ECRI (2021) Top 10 Patient Safety Concerns 2021. https://www. ecri.org/top-10-patient-safety-concerns-2021

ECRI acknowledges the role VAD dressings play in protecting patients from peripheral vascular harm. AUGUST / SEPTEMBER 2021 23

EDITORIAL PIECE: PICCPerfect Emily Levy | Co-Founder of Mighty Well

When you’re a newly turned 21-year-old college student, New Year’s Eve is a veritable highlight of the year. It’s a night to dress up, drink champagne and dance with your friends until the sun comes up. However, as the sun rose on the first day of 2015, I was not out dancing. As I lay in bed and scrolled through social media the following morning, swiping through an endless sea of smiling faces, I felt only an overwhelming sadness. My face was not among them because I was two days out from having my first PICC line placed and recovering at my parents’ house. College was hard enough, but add to that a diagnosis of tick borne illness, EBV, Hashimotos, CIDP, and POTS plus a PICC line? For the first time, I felt the full weight of the procedure upon me, and it seemed almost insurmountable. Almost. In the months leading up to the procedure, my worries hadn’t been nearly this great. I had been working with my Lyme-literate nurse practitioner for months, trying to find the right cocktail of antibiotics and supplements to relieve my symptoms. Nothing was working, and so we had arrived at the next step: a PICC line. Of course, on one hand, it was a reminder that I was critically ill. On the other hand, I was excited, because it felt like the next stop on my journey toward healing. After speaking with numerous patients who found success with a PICC line, I felt hopeful. It was during this time that I became fascinated with the inner workings of the device, truly kickstarting my investment into changing the landscape for other patients with vascular access devices. As I learned how to best protect my PICC line, I learned that the best any professional could recommend was a cut-off sock or stockinette. I was a young college student and a member of a scholarship program who often spoke in public settings; I couldn’t accept this.

24 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER

Thankfully, because of this program, I was encouraged to solve a problem in my own life through social entrepreneurship. I had my idea, a device to protect a PICC line, enabling me to live my life safely, sanitarily and securely, all while maintaining my style. The next step was execution. Holding the prototype for the PICCPerfect in my hands for the first time was an incredible feeling. While I wished so badly that I could have had something like this when my PICC line was placed, I was excited for the next generations of patients who would never have to suffer the cut-off sock. It was such an invigorating feeling to know the only thing left to do was to get it in the hands of patients. Thankfully, I had a college mentor who found the Association for Vascular Access (AVA) and encouraged me to attend a local network meeting. With my PICCPerfect prototype in hand and some light nerves in my stomach, I bought a ticket and showed up. As the only patient present, I was invited to share my story with the room. I soon became acquainted with the network and national organization. Ultimately, this first network meeting led to great amounts of growth, both for myself and for Mighty Well, the adaptive-clothing wear brand I co-founded. Throughout my journey as a patient, AVA has continually enabled me to champion my best treatment options. I fully trusted AVA and its members from the beginning. AVA members are the authority on vascular access, from start to finish. Everything from choosing the right device, to lifestyle, medication management and, ultimately, how the device is eventually removed. AVA helped me advocate to get a port placed. Then with the help of VA specialists, I learned how to access my own port. I cannot overstate how empowering it has been to regain some control of my body, medication and devices. This has been particularly crucial for me throughout CONTINUED ON NEXT PAGE

EMILY LEVY, CONTINUED FROM PREVIOUS PAGE the COVID-19 pandemic. I, like many other chronicillness patients, struggled with a lot of anxiety. While others were safely bunkered in their homes, I had to receive IVIG weeks into lock-down and had no choice but to allow someone into my home to administer my infusion. I had a great relationship with my home-care nurse, but of course I struggled with feeling safe and letting someone into my bubble. Ultimately, I needed my infusions, but it was a process to relearn trust in medical professionals. I truly don’t know how I could have survived the past year without the knowledge I gained from AVA. This knowledge helped me to both trust the medical professionals in my life and to trust myself with my own care. Often, patients feel a loss of agency in their bodies, which can be both discouraging and frustrating. Patients deserve to advocate for themselves, from the device that’s chosen, to the medication they take, to figuring out how to live a fulfilling life with a device. I will always be grateful to AVA for giving me this knowledge and empowering me to champion my own care. Another consequence has been the knowledge of how to spearhead the best possible products at Mighty Well. Now, following years of product development, with insight from both top vascular clinicians as well as patients, Mighty Well will release a product to take the PICCPerfect to the next level. I cannot wait to continue to work alongside AVA to get these devices and care products in the hands of patients who so desperately deserve the same feeling of agency and freedom I now have.

ABOUT THE AUTHOR Levy is an award-winning social impact entrepreneur, disability advocate, and public speaker. She cofounded Mighty Well based on her experience as a patient living with Lyme disease and vascular access devices. She has been honored by worldclass entrepreneurial programs, including the Cartier Women’s Initiative Awards, Morgan Stanley Multicultural Innovation Lab, MassChallenge, and is currently the youngest member of Babson College’s Hall of Fame as a Rising Star. Mighty Well creates innovative products in the Adaptive Wear market, which is expected to reach $393B by 2026 (CBS News), for the 133 million Americans who live with a chronic condition. Mighty Well applies sportswear fabric technology to the medical industry and is building a digitally supportive community of Friends in the Fight for our consumers. The PICCPerfect Pro was given FDA approval as a Class 1 device in 2020. Emily has spoken for: Fidelity Investments’ Boundless Summits, Becton Dickinson (BD), MedComp, The Association for Vascular Access, The Infusion Nurses Society, Tuft’s Health Plan, The United States Association for Small Business and Entrepreneurship, MassChallenge, Babson College, Wentworth Institute of Technology, Endicott College of Nursing, and other distinguished organizations. You can read about Mighty Well in The New York Times, The Wall Street Journal, Shondaland, and Forbes- to name a few. Connect: Emily@Mightywell.com

The mission of Mighty Well is to help patients and their caregivers turn sickness into strength. We are leading the global charge that changes the perception of patients from victims to fighters. We do this by improving the experience of being a patient. We create the products we wish we’d had: functional and stylish apparel and accessories that you can wear with confidence - and content that can help you get through the good times and the bad.

AUGUST / SEPTEMBER 2021 25

AVAILABLE NOW

RESOURCE GUIDE FOR VASCULAR ACCESS 2020

RESOURCE GUIDE FOR

SS VASCULAR ACCE de for Recommended Study Gui tiﬁcation Vascular Access Board Cer 1st Edition

The 2020 AVA Resource Guide for Vascular Access: AVA's Recommended Study Guide for Vascular Access Board Certification provides an overview of basic vascular access knowledge and covers essential elements that clinicians implement on a daily basis. Throughout the Resource Guide, readers have access to high definition images, videos, illustrations and engaging animations that give them a greater understanding of the concepts. The guide may be used to prepare for the vascular access board certification examination (VA-BC™), as well as serve as a resource throughout professional practice.

AVA MEMBER PRICE: $75 digital only $85 print $140 bundle (print and digital) NON AVA MEMBER PRICE: $90 digital only $100 print $165 bundle (print and digital)

Check out the Resource Guide https://www.youtube.com/channel/ sneak peak videos on UCP3i3q44bvmVdjjUclt9esw our YouTube channel!

PURCHASE IT ONLINE TODAY! Digital Access: • Your digital key will allow access on two devices • Corrections and incremental updates to version one will automatically populate your digital copy (no additional charge)

26 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER

S E P T. 16-19, 2021 Special Schedule The full virtual schedule is now online - click below to view our full conference offering!

Continuing Education

Virtual attendance at AVASM21 includes approx. 25 CE credits. Credits also count towards VA-BC.

On-Demand Content All of the virtual AVASM21 content is available to registrants through November 15th.

IT’S NOT TOO LATE TO REGISTER! Why Join Us ?

www.avainfo.org/register

CLICK HERE to regis ter today

AVA members can register for $350, and non-members for only $450! Sessions will have interactive Q&A and polling options for attendees. Full Exhibitor Resource Center & Educational Events Watch sessions via the AVASM21 app or on your laptop Join us from the comfort of home!

801-792-9079 877-924-AVA1

www.avainfo.org ava@avainfo.org

ANGEL

2021 ANGEL PARTNERS: Lineus Medical • MightyWell • SterileCare

2021 STRATEGIC PARTNERS: Access Vascular • Adhezion • Eloquest Healthcare •

Genentech • Hampton House Medical • Interrad/SecurAcath • Parker Laboratories

2021 ENTERPRISE PARTNERS:

3M • AngioDynamics • B. Braun Medical BD • PDI • Smiths Medical • PFM Medical • Teleﬂex

ACADEMY

Thank you to our loyal Industry Partners for sharing AVA’s mission. Email partner@avainfo.org to design a program that becomes an indispensable instrument for advancing education, awareness, adoption and expansion. 800.792.9079 EXT. 105 | PARTNER@AVAINFO.ORG | WWW.AVAINFO.ORG

AVA currently has 52 active networks The Association for Vascular Access is committed to providing an opportunity for members to broaden their knowledge of vascular access and related fields through networking opportunities and education. AVA Networks offer vascular access professionals the opportunity to network with other professionals in their area of expertise. Network meetings offer educational sharing opportunities, continuing education credits, dinner meetings and quality dynamic speakers.

Do You Know Where Your Nearest Network Is? w w w. ava i n f o . or g / n e t w or k s

The special enhanced edition of Vessel Health and Preservation: The Right Approach for Vascular Access is now available to purchase.

Get yours today for just $9.99! Hours of exclusive audio interviews with the authors discussing their areas of expertise are embedded into this version of the book, as well as animated videography capturing elements from actual vascular access procedures. AVA has also elevated the overall readability, and through Apple, Amazon and Barnes & Noble has added note-taking and flash card functionality for readers.

AUGUST / SEPTEMBER 2021 29

NETWORK NEWS GULFVAN GulfVAN is proud to continue Nina’s legacy and the strength of our Manny Matters community outreach program by sending a total of FOUR GulfVAN members to the Association of Vascular Access Scientific Meeting in September. All four wrote about their strong desire to attend the conference. All are recipients of the Nina Marie MarinoWilliams Scholarship that honors our 2017 Person of the Year who passed away in September 2018. Nina’s beautiful and inspirational story was shared internationally in People Magazine, Ellen, and as far away as Indonesia. Nina is remembered fondly by all who had the pleasure of calling her their friend. Her story can be found on our website at http://www.gulfvan.wildapricot.org/sys/ website/?pageId=1850934. GulfVAN has been dedicated to sending at least one GulfVAN member to the Association of Vascular Access Scientific Meeting every year in Nina’s honor. This year, we are excited to have these four clinicians represent GulfVAN: Megan Pacheco RN, Sheila Castle, BSN, RN, Liz McCoy RN, VA-BC, Christine Romano, RN. Please help us celebrate these special clinicians, some of which have been pursuing advanced degrees and certification during the pandemic. As we continue virtual collaborative meetings this year with FLAVAN, we are ready to see people in person at the national meeting. #NinasNation #MannyMatters

30 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER

Educational Offerings from AVA

Available anywhere you get your podcasts

I Save That Podcast

• Streaming on Spotify, SoundCloud, iTunes, Stitcher, Google Play Music, iHeart Radio, Pandora, Amazon Music •

Journal of the Association for Vascular Access I Save That Podcast

• Published quarterly • Streaming on Spotify, SoundCloud, iTunes, Stitcher, Google Play Music,3,000 iHeart Radio, Pandora, • Approximately subscribers Amazon Music •

Journal of the Association for Vascular Access

Intravascular Quarterly (IQ) • Published quarterly

• Approximately 3,000 subscribers • Published quarterly • E-newsletter sent to AVA members

ACADEMY ACADEMY

Intravascular Quarterly (IQ) • Published quarterly

• E-newsletter sent to AVA members AVA Academy

• Continuing Education courses ALL available on demand • AVA Procedural courses, webinars, scientiﬁc meeting Academy sessions, etc. • Continuing Education courses ALL available on demand • Procedural courses, webinars, scientiﬁc meeting sessions, etc.

AVA Resource Guide for Vascular Access

Resource Guide for Vascular • AVA Prepare for the VA-BC™ exam, Access as well as serve as a • Prepare for the VA-BC™ exam, as well as serve as a resource throughout professional resource throughout professional practice practice

Learn more at www.avainfo.org Learn more at www.avainfo.org

AUGUST / SEPTEMBER 2021 31

AVA Academy is always open!

ACADEMY

The Association for Vascular Access (AVA), in collaboration with The Clinician Exchange (TCX), launched a new, best-in-class learning management system tailored to aspiring and established vascular access clinicians. Providing cutting edge training, critically-acclaimed presentations from scientiﬁc meetings, journal review courses and much more, AVA Academy is a groundbreaking initiative that advances the heart of AVA’s mission – Protect the Patient | Educate the Clinician | Save the Line. Academy curriculum is now available to the public, and to active AVA members at a discount.

Looking to further your education but struggling to ﬁnd the time amidst a busy work schedule? AVA Academy is always open! It's our mission to create greater public awareness of vascular access and to empower our members with signiﬁcantly more educational resources, networking opportunities, and advocacy tools in support of and dedication to the patients that we are entrusted to serve.

AVA Academy is now open to all curious minds Choose and enroll in your classes today!

View Course Catalog

Launch My Courses

• Review course content, outlines and objectives

• Sign in to your personal AVA Academy Account

• Purchase courses

• Launch your courses

• Add courses to your personal Course List

• Take quizzes

• Available to Members, Non-members and all site visitors with a Guest Account

• Available to Members and Non-members with a Guest Account

• If you're not an AVA member, consider Joining AVA or you may create a Guest Account at no charge

• You will need to sign in to the AVA website prior to clicking Launch My Courses above

Learn more at www.avainfo.org/AcademyLaunch

You probably already know about the ISAVE That Line campaign AVA launched in 2006 to bring crucial principles of vascular access device management directly to the bedside. Putting patients first, ISAVE encourages and emphasizes a “back to basics” approach, essential to reducing the risk of infection and improving the management of all vascular access devices.

On the cliniciancentered version, ISAVE stands for:

Implement insertion care and maintenance bundles

Scrupulous hand hygiene

Always disinfect every needleless connector

Vein Preservation

Ensure Patency

Introducing our NEW addition to the ISAVE family that supports this program from the ground level: A patientfriendly version. Written and edited by patients and caregivers, this new resource is completely FREE as a downloadable PDF. Please share and distribute this resource in your facilities, with your colleagues, on your social media platforms, with your patients and with your family. We simply ask that you not amend it without prior permission from AVA.

On the patientcentered version, ISAVE stands for:

Inform us right away

See us check your IV often

Ask us to clean our hands

Value your veins

If you’d like laminated full-size sheet versions of this patient asset already printed, we have those available for sale in the AVA store in packs of 10 for $25.

Expect us to follow basic rules

Click here to purchase yours.

A Guide For Patients and Families

Remember, purchasing official ISAVE assets directly helps AVA advance its mission, which is Protect the Patient | Educate the Clinician | Save the Line. You can also support the AVA Foundation, which focuses on advancing Education, Research and Innovation in vascular access.

Take the pledge, be involved and join AVA in our mission to keep our patients free of infection!

Find out more online.

NFORM US RIGHT AWAY IF YOUR IV SITE HAS ANY

S A V E

S welling T emperature Change O ozing P ain

OF THE FOLLOWING:

EE US CHECK YOUR IV OFTEN

Is it working? Is there Swelling, Temperature change, Oozing, Pain? Is your IV dressing clean, dry and not peeling? Is your IV still needed?

SK US TO CLEAN OUR HANDS

Expect us to wash our hands or use hand sanitizer when going in and out of your room.

ALUE YOUR VEINS

We have technology to help us place your IV. If you are not getting IV fluids or medicines, you might not need an IV. Protect your IV from accidently getting pulled out.

XPECT US TO FOLLOW BASIC RULES:

We will talk with you about your IV needs. We will select the best IV for your care. We will choose the best site for your IV. We will ask for help if we cannot get your IV after 2 attempts. We will clean your skin before inserting your IV. We will scrub the end of your IV every time we use it.

www.avainfo.org

The information presented in this PDF is free to download and share and made available by The Association for Vascular Access (AVA) strictly for educational purposes. This document is meant to provide general information and understanding of Vascular Access devices and procedures. It is not meant to provide specific medical advice. AVA, it's Board of Directors, staff and members are not liable for outcomes associated with your care. AVA encourages the use of this document for Vascular Access education, provided it is not modified. Please share it with clinicians, patients and their families and attribute this resource to AVA. You may also include the links to our additional resources (if applicable). AVA's informational resources educate these clinicians, patients and their families to ensure they receive safe Vascular Access care. Feel free to print, post and share this document within your healthcare institution, as well as on social media. If you have questions, please contact ava@avainfo.org.

Stay up on the latest at www.avainfo.org/isavethatline

Subscribe no w on the following pla tforms:

WWW.AVAIN

FO.ORG/PODC

AST

HAVE YOU BEEN LISTENING? ISAVE That Podcast Season 4 Mitigating Bleeding and Oozing to Prevent Early Dressing Disruption Bleeding and oozing from the puncture site after the insertion of a vascular access device is a common problem in clinical practice. Lori Kaczmarek MSN, RN, VA-BC and Tara Fain BSN, RN, VA-BC join us to discuss the recent article published in the Intravascular Quarterly about how bleeding and oozing impacts the integrity of sterile dressings covering devices. Tara talks about her own clinical experiences implementing tissue adhesive as part of a strategy to reduce dressing disruption and early dressing changes at her facility. Check out the latest episode on any of your favorite podcast platforms. For the latest discussion on vascular access, please like and follow us on Facebook, Instagram, Twitter, or LinkedIn! Enjoy the show!

The Role of US Gel in US Guided PIV Insertion and the Value of Certification Ultrasound Guided Insertion is the best practice for the insertion of vascular access devices. There still exists different practices in how US gel is applied and its impact on patient safety and clinical outcomes. Dr. Nancy Moureau PhD, RN, CRNI(c), CPUI, VA-BC(tm) and Emily Smith BS, RDMS, RVT discuss this varying practice and options available to clinicians to help improve clinical outcomes. On the second segment of the podcast Ericka Godoy RN, VA-BC(tm) joins us as we discuss the value of certification in the specialty of vascular access. Ericka recently passed the boards and she shares her experience studying for the exam with the help of the AVA and Infusion Knowledge Count Down to Your Exam Webinar study bundle. A special thanks to CIVCO the sponsor of this episode of ISAVE That Podcast.

34 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER

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AUGUST / SEPTEMBER 2021 35

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Watch for the latest from JAVA

Check out our latest edition of:

Have you checked out the Spring Edition of JAVA yet?

AND BE ON THE LOOKOUT THE WINTER EDITION COMING SOON!

Behind on your CEs? AVA members have access to the CE article in each issue of JAVA! Simply read and complete the short quiz to receive 1.0 contact hour. Click here.

Learn more about JAVA here. The Journal of the Association for Vascular Access (JAVA) publishes original peer-reviewed feature articles related to the care and management of patients with vascular access devices. AVA members are the ‘trend-setters’ in the vascular access arena and are keeping up with the most current advancements in the industry.

1,500

CALL FOR MANUSCRIPTS

We invite you to submit original manuscripts in the field of Vascular Access. We are interested in receiving manuscripts on clinical practice, education and research related to vascular access including articles on vascular access manufacturing and technology, and vascular access care and maintenance issues in hospitals, home settings, hospice, and alternative care facilities. We also invite submissions to our Patient/Consumer Perspective column where we ask you to share personal stories or “lessons learned” about caring for, living with or having a vascular access device. In about 1000 words and in conversational style, present your story. You can submit on behalf of someone or encourage them to write it themselves.

FOR COMPLETE INSTRUCTIONS SEE:

Information for Authors at www.avajournal.com Or contact the JAVA Editor at JAVAEditor@avainfo.org

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Advertising space available on AVAinfo.org The Second Edition of the ‘Chart of Pediatric CVC Maintenance Bundles’ IS AVAILABLE AT AVAINFO.ORG/STORE

GET YOURS TODAY! Printed full color with gloss UV coating 13” x 19” size Package of 5 Members: $40 Non-members: $50 Shipping included

DO YOU LIKE WHAT YOU READ HERE? Would you like to be part of this publication? Do you have something interesting, informative or new going on in your place of practice? Have you cared for a special or interesting patient? Do you or your colleagues have new or innovative ways of doing things? Have you been to or presented to any meetings or conferences?

WE INVITE YOU TO SUBMIT FOR PUBLICATION Writing a submission does not mean that you have to write the next great American novel. It is more about presenting pertinent information in a brief, fun and creative way. Please submit to ava@avainfo.org

SUBMISSION DATES ARE: FEBRUARY 1 deadline for submissions for February issue MAY 1 deadline for submissions for May issue AUGUST 1 deadline for submissions for August issue NOVEMBER 1 deadline for submissions for November issue

Visit our website www.avainfo.org

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Association For Vascular Access www.linkedin.com/company/association-for-vascular-access/

Association For Vascular Access www.youtube.com/AssociationForVascularAccess

F O R C O M M E N T S OR S U G G E S T I O N S , P L E A S E S U B M I T T O AVA @ AVA I N F O . OR G Disclaimer: AVA (Association for Vascular Access) is a professional organization of vascular access professionals dedicated to improving vascular access practice and patient outcomes through education and other means. AVA publishes this periodic electronic newsletter for our membership and other interested parties for information purposes only. AVA distributes this electronic newsletter with the understanding that AVA is not engaged in rendering medical or professional service through the distribution of the IQ publication. AVA is not giving advice and does not subscribe to guarantee the accuracy or efficacy of the information provided. Privacy Policy and Unsubscribe Information -AVA maintains strict rules of confidence with regards to your email address and all other personal contact information. We will not, under any circumstances, sell, transfer, or provide your email address to any third party for any reason. Email lists are compiled on an opt-in basis by AVA for the sole purpose of distributing the IQ newsletter. AVA does not condone or participate in the distribution of unsolicited email. If you feel that you have received an email transmission from AVA in error, please contact AVA at info@avainfo.org and ask to be removed from the list. All removal requests are addressed promptly.

Intravascular Quarterly | IQ | Aug/Sept 2021

Articles inside

Welcome to Our Newest AVA Members

ISAVE That Line

Have You Been Listening? ISAVE That Podcast

ISAVE That Podcast

Network News

Editorial Piece: PICCPerfect

AVA 2021 Virtual Meeting

Quality Improvement Initiative: Maximizing Dressing Adherence to Minimize Infections

JAVA Reviewer Update

UltraDrape/Parker advertisement

The Use of Tissue Adhesive for Peripheral Intravenous and Arterial Catheters: A Survey of Clinician Experience

Allergic to Newbie IVs

Inside AVA: Notes from the Executive Team