The e-news publication of the Association for Vascular Access FEBRUARY 2021 | VOLUME XI | ISSUE 1
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.
SAVE THE DATE: SEPT. 16-19, 2021
IN THIS ISSUE Page 2
A Survey of Clinicians: Bringing Tissue Adhesive to the Neonatal Population
Page 5
Defend with Profend® advertisement and link
Page 6
AVA Leadership – Update, FYI and Call-out
Page 7
Parker UltraDrape™ advertisement and link
Page 8
AVA Volunteer Organizational Chart 2021
Page 10
New Members of AVA Board of Directors, 2021-2022
Page 12
Staff Spotlight: Cate Brennan, Chief Executive Officer
Page 14
Network News
Page 15
Needleless Connectors: New Standards, Still Confusing
Page 19
PediNeoSIG: Fun Facts About Our Team
Page 22
Beyond Acute Care SIG: Best Expectations, Worse Outcomes (Part II)
Page 25
CE and Other AVA Events
Page 27
Thank You to AVA Industry Partners
Page 28
ISAVE That Podcast Season 4 Updates
1 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER
For more information on the PediNeoSig and how to join: www.avainfo.org/pedineosig
A SURVEY OF CLINICIANS: BRINGING TISSUE ADHESIVE TO THE NEONATAL POPULATION Lori Kaczmarek, MSN, RN, VA-BC™ | 2021 AVA Presidential Advisor Vascular Access Clinical Specialist, Adhezion Biomedical, LLC
Perhaps the most exciting recent advancement in vascular access care and technology has come in the form of glue. Glue, or tissue adhesive (TA), has been around for many years, but it was not until September 2017 when the Food and Drug Administration (FDA) approved a unique formula specifically for vascular access devices (VADs) and with no age restrictions. And in just three short years, TA has been adopted by the Infusion Nurses Society (INS) in the recently published (January 2021) Infusion Therapy Practice Standards as a standard of care for all VADs.
landed me right in the heart of a busy NICU. I was amazed by the skill and dedication NICU vascular access and bedside clinicians demonstrated as they place and maintain VADs that to me looked like a piece of thread. The babies were so tiny that I quickly appreciated the unique challenge that came with securing and dressing the VAD. Unlike adults, there is zero tolerance for line migration and a limited surface area makes securement a far greater challenge. Over the last couple of years, I have traveled and engaged with clinicians from NICU, infant, and pediatric centers across the United States (US). My interest and desire to support the most fragile babies led me to conduct a comprehensive survey with clinicians about their experiences using TA in this population. What prompted them to explore TA? How does it contribute to VAD care in the NICU? And what changes came about because of glue?
For context and disclosure, I am a consultant for Adhezion Biomedical, LLC, makers of SecurePortIV® (SPIV) TA for vascular access. Prior to my tenure with the company, I practiced as the director of a vascular access team in southeast Wisconsin. Our Photo credit: Adhezion Biomedical, LLC 25-member team shared the same The healthcare landscape has certainly changed over challenges all clinicians do securing VADs, protecting the past 10-15 years. The advent of value analysis them, and, of course, minimizing the unscheduled teams and material management require a different dressing changes and migration issues. approach to trial and implementation of new products. While I understood the process of adding I cared for primarily adult patients in my 10 years new products to the adult population, neonates with the team, so I brought no direct, hands-on and infants were a new ballgame. The unique needs insertion or maintenance experience with the of infants and pre-term babies require multiple neonatal ICU (NICU) VADs. As luck would have it, my first clinical education support assignment for TA CONTINUED ON NEXT PAGE FEBRUARY 2021 | 2
A SURVEY OF CLINICIANS, CONTINUED FROM PREVIOUS PAGE stakeholder input prior to product trials. I wanted to better understand what process each used and who was involved in their product selection? What factors were considered? And how long did it take to trial this product and adopt it as part of their VAD toolbox? This qualitative survey explored many variables that every NICU clinician wants answered when they consider TA for their patients. Twenty-one NICU clinicians randomly selected from a database of consumers who implemented or were currently trialing TA were sent an electronic survey on Dec. 1, 2020. I received 11 responses, each representing a unique facility, by the survey close date Dec. 31, 2020. The title or position of respondents included Peripherally Inserted Central Catheter Registered Nurse (PICC-RN), Clinical Nurse Specialist (CNS), Neonatal CNS/Nurse Practitioner (NP), and Vascular Access Managers. The majority (n=6) of respondents said they first learned about TA from a colleague, four through conference attendance, and one from a vendor. The primary reasons for seeking a trial with TA was improve securement (n=9), manage line migration issues (n=9), and address bleeding or oozing of lines (n=7). Other issues include dissatisfaction with previous securement device (n=1) and skin integrity issues with previous securement device (n=1). Most (n=10) applied TA to PICC lines during their trial. Three also included central venous catheters (CVC), two also used the TA on umbilical catheters, three included peripheral IVs (PIV) in their trial while one focused their trial only on arterial lines. The key stakeholders involved in the decision to trial or implement TA included physicians or intensivists, infection prevention, advanced practice providers (APRN/PA), vascular access team (VAT), clinical nurse specialists (CNS) and bedside caregivers including RN’s and respiratory therapists (RT). Four identified value analysis (VA) also being included in the decision. I inquired about the length of their trial and how many applications were used to conclude about the safety and efficacy of TA on addressing their target goals. Interestingly, the trial period ranged from 12-150 days (average 62 days). One box of 3 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER
product includes 50 single-use TA applicators and the respondents averaged 48 applications (range 10-90), or roughly one box to conclude their trial. Given that six of these trials were initiated in 2020 during the COVID-19 pandemic, I expected these numbers might have been higher. Formal approval for implementation happened within 1-3 months at five of the facilities. One responded that they did not require additional approval. Three continued to use TA while awaiting formal approval. Only one required more than three months to receive approval and one facility is conducting a larger scale trial and expanding the device types for use. A common question that comes with TA use is how or when to remove the glue and what does that process look like? I asked and the clinician comments speak for themselves: • “The adhesive is only removed when needed. The site is cleaned with CHG and then (in-house standard adhesive remover) is used to remove the remainder of the glue.” • “We don’t use adhesive remover.” • “Use (in-house standard adhesive remover) wipes or spray and remove gently with gauze.” • “Soak the site with remover and let it sit for 30+/sec.” • “If line adjustment is needed within the first 7 days, apply a couple drops of adhesive remover to dissolve the glue prior to cleaning with CONTINUED ON NEXT PAGE
A SURVEY OF CLINICIANS, CONTINUED FROM PREVIOUS PAGE chlorhexidine. In most cases, use of adhesive remover is not required; the seal can be broken by gently lifting up on the catheter.” • “Most of the time the glue comes off with the dressing when dressing is removed. If glue remains, (in-house standard adhesive remover) wipe is used, and glue is easily removed with a few seconds of gentle application strokes.” The majority of respondents (n=6) identified a colleague as their first introduction to TA in the NICU, so I also asked what they would tell another colleague if they were asked about adding TA into their practice. Again, let’s hear it directly from them:
• That we have experienced less calls for dressing changes due to bleeding. That we have experienced only 2 dislodged PICC lines since tracking data. One of which was not using (TA) in home setting and one was patient with terrible eczema and had oils all over skin.” All of the respondents shared that they realized multiple improvements in their NICU vascular access care and management including:
• “The product has definitely resolved the line migration issue, and in addition, we are now at month 22 without a single defined catheter line associated bloodstream infection (CLABSI).” • “I think it is a good product. I would encourage them to trial it.” • “To consider its use if they have an existing issue. Start with trial and track data. Nice option to have.” • “Absolutely love the product. It significantly improved securement for our lines, as well as an added layer of protection to potential bloodstream infections (BSI).” • “Easy to use. Good customer service.” • “I would recommend use based on success in most of our patients but share with them our experience with using it in preterm/neonates.” • “Very pleased with the product and would recommend use in the NICU. We have used down to 500gms without incident.” • “In theory this is a great concept.” • “Absolutely add. Well worth the small price for the added benefits.” • “Primary benefit with (TA) has been reduction in oozing/bleeding at the insertion site for PICC placement. We recently converted to a new EMR platform (Epic); report requests are still pending for how often dressings are being changed. Intensivists were in-serviced on use of the product for CVCs, but we do not have a mechanism in place for tracking how often it is being used for their line insertions.”
CONTINUED ON NEXT PAGE FEBRUARY 2021 | 4
A SURVEY OF CLINICIANS, CONTINUED FROM PREVIOUS PAGE Though small and limited in scope, this survey does provide relevant feedback for neonatal clinicians and specialists that are struggling with the same vascular access challenges identified here. There is hesitancy to bring new technology to this population in general and a perception that large data sets are needed before consideration. Even greater is the idea that others should initiate new technology first or the perception that the time commitment too intense. On the contrary, the growing body of evidence supports the use of tissue adhesive in the neonate population. Here, clinicians provided significant and useful insight about the process and key stakeholders they engaged to trial tissue adhesive in their NICU. We can learn much from these pioneers who followed a framework to methodically identify issues, research options, and propose alternatives to improve patient outcomes. They were able to complete the process with impressive efficiency. The process can be replicated for any new technology being considered. Survey respondents commented about the importance of data collection. As sophisticated as our electronic medical records (EMRs) are, they lack the flexibility to rapidly adjust to changes made in the clinical setting like trialing new technology. Successful product evaluation and implementation of any kind requires baseline and post implementation data. Clinicians report delays in starting their trial or receiving approval to implement due to data shortfalls. Consider short-term, limited-variable data collections using spreadsheets or paper evaluation forms. Electronic database applications can speed the time, efficiency, and accuracy to collect the needed information. Your organization’s informatics team may be a great resource to recommend an
5 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER
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application to use and help set it up. Bottom line: Respondents who successfully implemented tissue adhesive in their NICU established a data-tracking mechanism as a critical component of the process. If you are interested in more information about TA and developing a strategy to trial in your organization, please do not hesitate to contact me. References are also willing to speak with like-minded clinicians and share their experience using TA in the NICU and their process to make a trial happen. In closing, I wish to express my gratitude to those who participated in this survey. Knowing others have forged a path to change practice makes it easier for those who want to do the same yet may be struggling with first steps. Communicating process and outcomes is essential both within and beyond the walls of your organization. Your time invested to share your experience helps mentor others and is valued.
AVA LEADERSHIP – UPDATE, FYI AND CALL-OUT Jocelyn Grecia Hill, MN, RN, CVAA (c), VA-BC™ President, Association for Vascular Access
we could by “zooming in.” We were able to discuss, The start of 2021 brings us hope explore and expand on the AVA mission, vision and and excitement no matter where current strategic plan which are key to AVA’s success you live or work in the world. in 2021 and beyond. As much as we want to move on quickly from the challenges The following pages include the AVA organizational we faced in 2020, we are still chart and complete list of board members. I encourage feeling and seeing the pressure, you to learn more about your leaders’ passions on demands and effects of the novel our website. Please see the organizational chart on SARS- CoV-2 pandemic. I wish everyone health page 8. and safety as we navigate through more testing (those nasopharyngeal swabs One question commonly asked is are NOT fun) and vaccinations. I how board members are selected, know AVA members, as vascular voted on and elected. Since access specialists, continue to 2017, the Board Development be important team members Committee (BDC) is tasked and clinicians in the everyday “To lead health care and is generally responsible provision of patient care. I for identifying, mentoring and by protecting patients appreciate our industry partners developing volunteer leaders and providers to who have staff in the field that for AVA. The BDC develops and improve lives.” are doing what they can to help recommends a slate of officers support best practice as well as and directors-at-large and works continue to work on innovation in diligently to determine what our space. I know I am not alone specific experience or expertise in missing the in-person and faceis needed on the board. We to-face contact and networking seek to have a diverse board in “A world with safe at events and meetings. And it is all aspects, geography, practice vascular access.” with a sense of optimism that I am settings, business acumen, and life pleased to announce that we ARE experiences. The BDC chooses a planning a face-to-face meeting slate of candidates from a robust format for our 35th Annual Scientific Meeting, Sept. recruiting and self-nominating process, proceeds 16-19 at the Gaylord Palms in Orlando, Fla. We are with the vetting process and then presents the slate continuously monitoring the many facets to ensure to the AVA board for approval. And finally, the general attendee and exhibitor safety, satisfaction and membership votes on the entire slate of candidates participation – we will keep everyone updated. in a Yes or No vote. We have had great success in bringing on quality and committed volunteers to our As the 2021 president of the AVA Board, I had board. the honour of welcoming our new and returning members of the board of directors at the AVA virtual So, what does a board member actually do? First and board retreat a few weeks ago. We welcomed the foremost, the board works to achieve the mission new board members: Staci Harrison, DNP, RN; and vision of AVA. The AVA mission is “To lead health Swapna Kakani, MPH; Nael Mhaissen, MD. The care by protecting patients and providers to improve virtual meeting format is something we have all had lives.” The AVA vision is “A world with safe vascular to quickly adapt to and I am grateful for the board access.” Obvious and unquestionable, but lofty goals participating as we got to know each other as best CONTINUED ON NEXT PAGE
AVA MISSION:
AVA VISION:
FEBRUARY 2021 | 6
AVA LEADERSHIP UPDATE, CONTINUED FROM PREVIOUS PAGE nonetheless. The work of the board is guided but the strategic plan with the pillars of Membership, Education and Innovation; you can learn more on the AVA website. In addition, the board is legally responsible for all aspects of the financial, legal and operational health of AVA as a non-profit organization. It is responsible for ensuring the trust of its members and delivery of great products and services of value to the membership. Specific duties of all U.S.-based non-profit organizations are: • Duty of Care: To take AVA matters seriously and devote appropriate time to well-reasoned decision making. It is not about ‘rubber-stamping’ decisions but ensuring transparency and thorough discussion to reach decisions with AVA’s best in interest as a priority. • Duty of Loyalty: Decisions are always based upon what is best for AVA. There is a strict conflict of interest policy that is adhered to. • Duty of Obedience: I know this sounds funny, but it means to obey applicable laws and regulations and act in accordance with ethical practices and internal AVA policies. This also includes a commitment to adherence to our stated corporate purposes and activities to advance AVA’s mission. • Duty of Confidentiality: I know this can sound contrary to transparency, but it allows board members to freely debate the merits of an issue. The final actions of the board are what counts, and AVA is committed to that transparency on the outcomes. • Duty of Foresight: This means the board is committed to be visionary and future-looking. As healthcare professionals, most of us are used to tracking and relying on data and outcomes. So perhaps it should come easy for members of the AVA board to focus on the future by studying and considering professional, industry and societal data and trends. Relevant examples of this are in important questions we ponder now: 1) how we will interact with each other and continue to network in response to the current pandemic and when the pandemic ends (we can always hope it will end; but we know it may very well change how we work and live for a long time;) and 2) how we 7 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER
will continue to move forward to achieve the AVA mission and vision locally, regionally, nationally and internationally. My call-out and request: Think about where you can contribute your leadership skills and passion. It could be an AVA network, a committee or council and even the board of directors. Every organization is strengthened by the participation of its members and their diverse voices. I’d like to hear yours at avapresident@avainfo.org In closing, I want to thank each of you for your work in our specialty, at or near the bedside, in the communities and as industry partners. It has been a challenging time for everyone professionally and personally and I look forward to “seeing” you all virtually for now through AVA in our webinars, podcasts, and through social media. Stay tuned and connected to AVA for the latest and greatest in vascular access. I appreciate you all as we work towards our 2021 goals: (the AVA tagline) Protect the Patient. Educate the Clinician. Save the Line.
AVA VOLUNTEER ORGANIZATIONAL CHART 2021
AVA MEMBERS BOARD
BOARD
BOARD
(Vascular Access Certification Corporation)
Executive Staff CEO/COO
AVA Staff Bylaws & Policy Committee
BDC (Board Development Committee)
D-Team (Conference Planning)
MEC
CRT
(Member Engagement Committee)
(Clinical Review Team)
Networks
PediNeoSIG
BACSIG
(Pediatric/Neonatal)
(Beyond Acute Care)
CPG
PARG
(Clinical Practice Guidelines Task Force)
(Resource Guide Revision Task Force)
FEBRUARY 2021 | 8
AVAILABLE NOW
2020 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: $85 print $75 digital only $140 bundle (print and digital) NON AVA MEMBER PRICE: $100 print $90 digital only $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 (at no additional charge)
9 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER
NEW MEMBERS OF AVA BOARD OF DIRECTORS, 2021-2022
SWAPNA KAKANI, MPH 2021-22 DIRECTOR-AT-LARGE Swapna Kakani is a sought-after professional speaker and healthcare advocate. Her inspirational life story with Short Bowel Syndrome and a Small Intestine Transplant shows audiences her individual resilience and self-determination in the face of constant difficulties,
as well as the impact her healthcare advocacy has across disciplines. She has successfully helped both patients and clinicians be better patient advocates at every access point. She has required a central venous catheter for 28 years and is proud to be infection free for 13 years. Through her platform, Swapna Speaks, Swapna has given several presentations, sharing her valuable insight across the world to various healthcare companies and associations, hospitals, and non-profit events, including the AVA and NHIA conferences, the Cleveland Clinic Patient Experience Summit, and a TEDx talk in 2017. Swapna does healthcare advocacy work both at the federal and state level for the Short Bowel Syndrome/Small Intestine Transplant and broader rare disease community. She has been part of various projects to improve care and maintenance for IV and enteral nutrition consumers and part of policy and regulation changes to improve the rare disease patient experience. Swapna has received awards for her advocacy work including the consumer advocacy award by the American Society for Parenteral and Enteral Nutrition, a nomination for patient leader hero by Wego Health, and most recently in 2020, the advocator and innovator award by the Oley Foundation. Originally from Huntsville, Alabama, Swapna received a Bachelor’s degree in Psychology and Master’s Degree in Public Health from the University of Alabama at Birmingham (UAB).
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
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
FOUNDATION OPERATIONS MANAGER
MEMBER & NETWORK MANAGER
cbrennan@avainfo.org
bgore@avainfo.org
jlivsey@avainfo.org
CHIEF OPERATIONS OFFICER
CLINICAL EDUCATION SPECIALIST
NAEL MHAISSEN, MD
AVA STAFF CATE BRENNAN, MBA, CAE
TONYA HUTCHISON, CAE thutchison@avainfo.org
BETH GORE
BLAKE HOTCHKISS, BSN, RN, CCRN, CRNI, VA-BC™
JENNIFER LIVSEY
DIRECTOR OF CLINICAL EDUCATION
JUDY THOMPSON, MSNEd., RN, VA-BC™ jthompson@avainfo.org
bhotchkiss@avainfo.org
FEBRUARY 2021 | 10
NEW MEMBERS OF AVA BOARD OF DIRECTORS, 2021-2022
STACI HARRISON, DNP, RN
NAEL MHAISSEN, MD
2021-22 DIRECTOR-AT-LARGE
2021-22 DIRECTOR-AT-LARGE
Staci Harrison is an innovative leader with more than 25 years of experience in nursing. Currently, she serves as the Southern California Regional Director of MedicalSurgical and Critical Care for Kaiser Permanente, where she leads the vascular access workgroup. Staci has proven success in leadership roles where she has collaborated with groups to achieve excellent patient care outcomes. She has been instrumental in fostering the collaborative efforts across the Kaiser Healthcare system while leading the vascular access workgroup. After earning her Doctor of Nursing Practice in 2017, she lends her knowledge at various universities as an instructor in their online curriculum. As a member of the board, she will utilize her collaborative and leadership skills to transport the mission and vision of AVA. As evidenced by the success enjoyed by the Kaiser workgroup, Staci’s passion for vascular access exceeds all expectations. Healthcare needs that passion and Staci’s collaborative leadership now more so today than ever, and she along with AVA will be there to lead the way.
Nael Mhaissen is a pediatric infectious disease physician at Valley Children’s Healthcare in Madera, California, where he has been serving in different leadership roles including: the medical director of the infectious disease division, the medical director of infection prevention and control, and the chair of the health information management committee. He also chairs the committee of vascular access safety, which is a collaborative workgroup he created joining the efforts and expertise of the vascular access and the infection prevention teams and shifting the paradigm from focusing on preventing CLABSIs to focusing on preventing ALL vascular access related safety issues.
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Dr. Mhaissen believes that improving the quality of care and ensuring patient safety require a comprehensive and multidisciplinary approach that breaks the boundaries between the different disciplines and brings everyone’s expertise and goals together rather than focusing on the individual problems in silo. As a member of the board, Dr. Mhaissen hopes to serve as a liaison between the vascular access specialists and the infection preventionists and hospital epidemiologists and bring them together to elevate the quality of patient care when it comes to vascular access and vascular health.
STAFF SPOTLIGHT CATE BRENNAN, MBA, CAE: CHIEF EXECUTIVE OFFICER MY SUPPORT SYSTEM: Family, longtime friends and boyfriend. I have three sisters and two brothers. I am the fourth—a middle child. I have one adult son, and my world still centers around him.
MY FAVORITE MOVIE: Local Hero, an obscure 1983 Scottish comedy-drama film written and directed by Bill Forsyth and starring Peter Riegert, Denis Lawson, Fulton Mackay and Burt Lancaster. I like this movie because it’s about community, growth, change and values. MY FAVORITE QUOTE: “Never doubt that a small group of thoughtful, committed, citizens can change the world. Indeed, it is the only thing that ever has.” Margaret Mead, cultural anthropologist. I found this quote as a young teenager and it is one of the reasons why I have built my career in non-profit management. MY FAVORITE CITY: New York City, my adopted hometown for the past sevenplus years. It is intense living here but as they say: If you can make it here, you can make it anywhere. MY ESCAPE: The beach because I find ocean sounds soothing and healing. And I love the sun and swimming. MY ROOTS: Texas, specifically Dallas—I will always be a Texan. Also journalism, my bachelor’s degree—I like to understand all sides of a story. WHAT DO YOU ENJOY ABOUT WORKING FOR AVA: I enjoy the positive energy and enthusiasm of the leadership, members, industry partners and staff. WHAT DO YOU DO AT AVA: I work with the Board of Directors and AVA Foundation to help steer and execute their missions and strategic plans for maximum impact and success; advocate and raise awareness of the importance of the profession, vascular access team and patient safety; help with new product development and member value; provide leadership and outreach to other organizations, corporate partners and government agencies; and ensure best practices in association management and staff, along with Tonya Hutchinson. I’m good at creating and innovating. FEBRUARY 2021 | 12
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.
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
13 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER and providers to improve lives
VISION
A world with safe vascular access
NETWORK NEWS FLAVAN Caitlin Soldati, BSN, RN, VA-BC™ | FLAVAN Secretary
FLAVAN had an eventful winter and we are looking forward to a fantastic 2021 after much pivoting in 2020!! We are so excited to welcome our newest board member, Treasurer Crystal Penna, BSN, RN. Crystal joins our board with extensive pediatric vascular access experience, specifically implementing ultrasound guided peripheral IV insertion at her previous Ohio facility.
Like many other networks, we transitioned to virtual meetings in 2020. We averaged two meetings per quarter for our members, which were co-sponsored with other Florida networks. Our first meeting of 2021 was scheduled for February 4th, 2021, in collaboration with GulfVAN and BOCAVA. Our congratulations go to its new President Jami Lung! We were energized to see such great involvement in 2020. We look forward to connecting with our members virtually in 2021 and until we can meet in person again.
For FLAVAN news and upcoming events visit our website at flavan.wildapricot.org and like us on Facebook! Diana Melton, MSHA, RN, CRNI, VA-BC™ FLAVAN President
Caitlin Soldati, BSN, RN, VA-BC™ FLAVAN Secretary
Meagan Capen, MSN, RN, VA-BC™ FLAVAN President Elect
Crystal Penna, BSN, RN FLAVAN Treasurer
GULFVAN Sandra Mehner, RN, VA-BC™ | GulfVAN Secretary and Treasurer
Well, 2020 ended up being a crazy year that inspired creative ways to hold our network meetings! Social distancing became a must, and we held our meetings via Zoom or other types of video communications. We were able to resume our meetings in August and held our last meeting of the year in December. Silverlon sponsored the meeting, with Lisa Anstett, RN, OCN serving as the speaker. The topic: The History and Science of Silver in Managing Infections in Vascular Access. This was a great topic!
We look forward to this new year. Our next meeting was scheduled for Feb. 4, 2021. We are set to be partners with FLAVAN to learn Best Practice Reprocessing for Ultrasound. Lisa Hill, MSN, RN will be presenting and we are excited to learn more! We would like to say thank you to Nanosonics in advance for sponsoring this meeting. Moving forward in 2021, GulfVAN will continue to hold socially distant meetings. We will carry on with our scholarships honoring Nina Marie MarinoWilliams.
FEBRUARY 2021 | 14
NEEDLELESS CONNECTORS: NEW STANDARDS, STILL CONFUSING Matt Gibson, Chief Executive Officer for Vascular Access Consulting, LLC
How exciting it is to have the new Infusion Therapy Standards of Practice (SOP). One area of interest is needleless connectors (NC). Many clinicians find differentiating NCs and how to use them confusing.1 A common question I hear is, “What is the difference between neutral and anti-reflux NCs?” The way the SOP discusses these labeled connectors seems to be nearly the same. However, the labels come from the manufacturer’s marketing descriptions2, and there are no established quantitative criteria from device regulatory agencies that determine which device belongs to each category. The neutral NC is described in the SOP glossary3 as, “Contains an internal mechanism designed to reduce blood reflux into the vascular access device (VAD) lumen upon connection or disconnection.” This definition is different from the 2016 SOP4, where the term described as “internal mechanism to prevent blood reflux” which both definitions, 2016 and 2021, more closely describes the anti-reflux NC. Neutral, antireflux as well as negative connectors have a straight fluid pathway, but the anti-reflux is the only one that has an internal mechanism to reduce or prevent blood reflux. The differences between the anti-reflux technology and other NC categories are the volume of reflux (see Table 1) and bidirectional flow control5. When the vein’s pressure is higher than in the infusion system, the dome-shaped silicon diaphragm closes independent of the clinician dependent clamping. It will prevent the retrograde flow of blood into the catheter lumen and infusion system. More confusion with the glossary terms is with positive displacement NCs. The new SOP definitions tell us that the positive displacement NCs, having a complex fluid pathway, “Allows blood reflux on connection and disconnection.” This statement is a little confusing for the reader. As written, it implies that this type of connector refluxes, both when connection and disconnection occur. However, 15 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER
all NCs will only reflux during one phase of the connection-disconnection cycle6-8. Look at Table 1 (on following page). It is clear that all NCs reflux blood. The difference is when and how much occurs. Negative displacement, neutral and anti-reflux NCs reflux on disconnection, and positive NC reflux on connection. Generally, the neutral label connectors list less reflux than other first-generation negative connectors.
Why is this so important, you ask? Because up to 32 percent and 36 percent of catheters, PIVCs and CVCs, respectively, have occlusions9,10 leading to delays of treatment, increase risk of infection, catheter failure, and device replacement9,11-13. The SOP (36 B 1) states for neutral and anti-reflux connectors, “no specific sequence required” 3. This author’s opinion is that, this direction is not the best recommendation for connectors labeled as “neutral” considering the reflux volume listed for each NC (see Table 1). By not clamping the neutral NCs prior to disconnection will allow blood to reflux into the catheter. My recommendation is for end-users is to forget the idea that anything about the needleless connector is neutral. In the simplest of terms, all negative, neutral, and anti-reflux needleless connectors will reflux blood on disconnection. The difference is the volume. Clinicians will minimize reflux by engaging the clamp before disconnection occurs. CONTINUED ON NEXT PAGE
NEEDLELESS CONNECTORS, CONTINUED FROM PREVIOUS PAGE Positive needleless connectors will reflux on connection. Clinicians will minimize reflux by assuring the clamp is engaged before connection, apply slight plunger pressure when unclamping, then re-clamp after the syringe is disconnected. Remember, all devices should be flushed thoroughly prior to disconnection regardless of type of NC is use. Consider this definition of anti-reflux NCs to help you better understand. I have combined the definitions from neutral and anti-reflux to clarify the definition of anti-reflux.
ALTERNATE OR PROPOSED DEFINITION OF ANTI-REFLUX NEEDLELESS CONNECTOR: Anti-reflux NCs contains a straight fluid pathway with a 3-position pressure-activated silicone diaphragm (anti-reflux definition) designed to reduce blood reflux into the VAD lumen upon connection or disconnection (neutral definition). The diaphragm opens and closes based on infusion pressure (antireflux). However, the sequence of flushing, clamping, and disconnecting the syringe may improve patency (neutral definition). CONTINUED ON NEXT PAGE
TABLE 1 Table 1 describes the volume of reflux and when it occurs based on three published articles. Gibson8, Hull6, and Eli7. (*NOTE: If more than one volume listed from the articles, the author averaged the volumes.) Volume of reflux Gibson, Hull and Eli
Connector Label2,6,8
Reflux occurs on connection or disconnection
Nexus TKO-6P
0.09 µL
Anti-reflux
Disconnection
BD Neutra-Clear
0.33 µL
Anti-reflux
Disconnection
ICU Medical Neutron
0.60 µL
Anti-reflux
Disconnection
Bionector
1.24 µL
Neutral*
Disconnection
Dasa
2.38 µL
None
Disconnection
Nexus NIS
2.79 µL
Neutral*
Disconnection
RyMEd Invision
4.05 µL
Neutral*
Disconnection
Baxter One Link
6.14 µL
Negative
Disconnection
ICU Medical Clave
7.98 µL
Negative
Disconnection
ICU Medical Microclave
8.29 µL
Neutral*
Disconnection
Neutra-Clear
9.36 µL
Neutral*
Disconnection
BD MaxZero
12.87 µL
Zero Reflux, neutral*, anti-reflux
Connection
Baxter Interlink
13.18 µL
Negative
Disconnection
BBraun Caresite
14.98 µL
Positive
Connection
BD MaxPlus
24.85 µL
Positive
Connection
BBraun Ultrasite
36.63 µL
Positive
Connection
BD Q Syte
38.34 µL
Negative
Disconnection
BD Smartsite
41.10 µL
Negative
Disconnection
Baxter Clearlink
118.98 µL
Negative
Disconnection
Brand/ Model
*NOTE: When reflux occurs on disconnection, the clamp should be engaged prior to disconnection. When reflux occurs on connection, clamp should be engaged prior to connection with positive pressure on syringe plunger prior to unclamping.
FEBRUARY 2021 | 16
NEEDLELESS CONNECTORS, CONTINUED FROM PREVIOUS PAGE The neutral NC becomes a part of the definition of negative displacement NC because both refluxes in the same way. The rationale behind the recommendation is related to the management of the device. Despite what the industry has told the clinicians, neutral NCs have reflux and would benefit by clamping before disconnection. This is the same care needed for negative NCs. Clinicians can provide excellent patient care with any type of needleless connector through precise flushing techniques and timely clamping every connection-disconnection sequence, every time! No matter what connector you are using in your facility, make it a priority that every person knows the right way to flush and clamp your device.
REFERENCES 1. Hadaway L. Needleless connectors: improving practice, reducing risks. Journal of the Association for Vascular Access 2011; 16(1): 20-33. 2. Hadaway L, Richardson D. Needleless connectors: a primer on terminology. Journal of Infusion Nursing 2010; 33(1): 22-31. 3. Gorski l ea. Infusion Therapy Standards of Place 8th edition. 2021. 4. Gorski L HL, Hagle ME, McGoldrick M, Orr M, Doellman D. Infusion therapy standards of practice. J Infus Nurs 2016; 39 (suppl 1): S1-S159. 5. Gibson m. In Vitro Evaluation of Needleless Connectors: Testing Bi-directional Flow Control and Quantifying Reflux. 2020. 6. Hull GJ, Moureau NL, Sengupta S. Quantitative assessment of reflux in commercially available needlefree IV connectors. The Journal of Vascular Access 2018; 19(1): 12-22. 7. Elli S, Abbruzzese C, Cannizzo L, Lucchini A. In vitro evaluation of fluid reflux after flushing different types of needleless connectors. The Journal of Vascular Access 2016; 17(5): 429-34. 8. Gibson SM, Primeaux J. Do Needleless Connector Manufacturer Claims on Bidirectional Flow and Reflux Equate to In Vitro Quantification of Fluid Movement? Journal of the Association for Vascular Access 2020. 9. Helm RE, Klausner JD, Klemperer JD, Flint LM, Huang E. Accepted but unacceptable: peripheral IV catheter failure. J Infus Nurs 2015; 38(3): 189-203.
17 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER
10. Ernst FR, Chen E, Lipkin C, Tayama D, Amin AN. Comparison of hospital length of stay, costs, and readmissions of alteplase versus catheter replacement among patients with occluded central venous catheters. Journal of hospital medicine 2014; 9(8): 490-6. 11. Thakarar K, Collins M, Kwong L, Sulis C, Korn C, Bhadelia N. The role of tissue plasminogen activator (alteplase) use and systemic hypercoagulability in central line-associated bloodstream infections. American journal of infection control 2014; 42(4): 417-20. 12. Rowan CM, Miller KE, Beardsley AL, et al. Alteplase use for malfunctioning central venous catheters correlates with catheter-associated bloodstream infections. Pediatric Critical Care Medicine | Society of Critical Care Medicine 2013; 14(3): 306-9. 13. Jones RK. Short Peripheral Catheter Quality and Economics: The Intravenous Quotient. Journal of Infusion Nursing 2018; 41(6): 365-71.
Disclosure of relevant financial relationships: 1. Consultant for: B Braun, Nexus Medical, Interrad Medical, PICC Excellence, The Clinician Exchange, Ethicon, Access Vascular, Adhezion Biomedical LLC, Eloquest 2. Grant/Research support from: Beaumont Hospital Research Institute Royal Oak Michigan, Deaconess Clinic Research Institute, Evansville, Indiana 3. Honoraria from Association for Vascular Access (AVA) Since 1993 Matt Gibson has worked in nursing vascular access was both a primary and essential skill, including emergency department, ICU/telemetry, house supervisor, home infusion and long-term care vascular access team. Gibson currently works with multiple organizations as a vascular access consultant and speaker. He is certified registered nurse infusion, vascular access board certified and certified PICC ultrasound user. He has served on the AVA PIV task force, is a past-president and founder of the Kentucky Indiana Vascular Access Network, current president of Michigan Association of Vascular Access Network and presidential advisor for the InndiVAN.
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FEBRUARY 2021 | 18
For more information on the PediNeoSig and how to join: www.avainfo.org/pedineosig
FUN FACTS ABOUT OUR PEDINEOSIG TEAM
LISA SHEEHAN
ANGELA ALDERMAN The PediNeoSig wants to welcome all of those that have chosen to provide quality vascular access from neonates to adolescents. We are honored to have such a dedicated group of individuals that serve on the Executive Leadership Council (ELC) of the SIG. We are looking forward to our AVA Scientific Meeting in September, and continue to work on impactful projects, such as the PICC insertion course and Neonatal/ Pediatric Resource Guide. I am honored to serve as the PediNeoSig chair and am pleased to introduce our oncoming board for 2021. In the spirit of fun here are five fun facts about me! The majority of my vascular access career has been spent in the neonatal ICU. My favorite designer is Lilly Pulitzer. Her patterns and color choices fit my bright and happy personality. I am an excellent pie baker with apple being my specialty. I adore my family with my most favorite person being my grandmother Patricia. Finally, my favorite place in the world is a small beach town called Duck
19 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER
Hello from the home of the Pittsburgh Steelers! My name is Lisa Sheehan and I am serving the PediNeoSIG this year as Director at Large after serving the past 2 years as the D-Team liaison. I am looking forward to working with this close, dynamic group on projects that will improve the care provided to children in need. Here are five fun facts about myself to let you know who is working for you behind the scenes. 1) I have two fat and happy ragdoll cats, Molly and Milo, five and three years old, respectively. 2) I am an avid cyclist and thrilled that I got a new road bike for Christmas! 3) I recently lost 90 pounds and have learned over the past one and a half years to put my health first and exercise every day, without exception. I am much happier because of it. 4) I did a triathlon when I was in my late 20’s and wish to do another one to prove I’ve still got it. 5) I’ll be celebrating my 10th wedding anniversary this year and can’t wait to return to Ireland with my husband to celebrate, when I can actually leave the country that is!
MARY BETH HOVDA DAVIS Hello! Mary Beth here from sometimes snowy, sometimes sunny Iowa! I am stepping down from PediNeoSIG chair this year and will serve on the ELC as the chair advisor. I’m really excited for the work we have ahead of us and to continue to help develop innovative solutions to improving kid’s vascular access! Five fun facts about me: 1) I knew I wanted to be a pediatric nurse since my senior year in high school and my first job was on a pediatric oncology unit at the University of Iowa Children’s Hospital. 2) I LOVE to travel and used to explore a new country every year. Since having kids, we’ve been exploring the USA, but I can’t wait to dust off my passport again. 3) Inspired by my AVA peers, I’m in my second year of my PhD program, specializing in pediatric vascular access (thanks AVATAR!). 4) I love meeting new people, especially at a karaoke/piano bar. 5) Family and friends mean the world to me and I’m happy to know many in the AVA universe.
KATIE FRATE My name is Katie Frate and I am the current secretary of the PediNeoSig ELC. This is my second year serving on the ELC. I currently reside in Tampa, Fla. with my husband Nick and two children, Aria and John Anthony. I am a member of the Pediatric Vascular Access Team at St. Joseph Children’s in Tampa. I have worked in pediatrics my entire career and absolutely love what I do. One of my top bucket list items is to travel to Italy and enjoy all of the delicious food. I look forward to continuing to serve on our pediatric and leadership community and help to provide the best clinical outcomes for our most vulnerable population!
KACEY WISEMAN Hello! My name is Kacey Wiseman, and I feel so privileged to be a part of this amazing group! This is my first year serving on the ELC as Director as Large and D-Team Liaison. I have been a pediatric nurse for my entire career. Currently, I work at Boston Children’s Hospital as a member of the Vascular Access Service. Here are five fun facts about me: 1) My favorite place to be is out in the sun by the water, whether it is on the beach or whitewater rafting. 2) I love live music. 3) I enjoy watching sports, especially college basketball - Go SU! 4) Cooking and baking are favorite pastimes of mine. 5) I am endlessly grateful for my family and friends, including my two Ragdoll cats named Charlotte and Winston.
FEBRUARY 2021 | 20
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!
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BEST EXPECTATIONS, WORSE OUTCOMES (PART II): A PATIENT AND FAMILY EXPERIENCE WITH RURAL HOME INFUSION
Erik Samarpan, RN, VA-BC™, LNC | Board Certified in Vascular Access; Legal Nurse Consultant; Oncology Credentialed; Infusion Specialist; BACSIG (Beyond Acute Care SIG) Director-at-Large
Continued from the November 2020 IQ Names changed for privacy To quickly recap our case presentation from the November 2020 issue of IQ, Jose is an 8-year-old Hispanic male with recently diagnosed Duchene’s Muscular Dystrophy (DMD) residing with his family in a rural, mountainous rural area of Northern Arizona. His mother, Marie, speaks English and acts as the interpreter when Jose does not understand my explanations and instructions. Unfortunately, Jose has had less than positive experiences related to the care and management of his implanted port. He also has had difficulties with the infusion of the Axon skipping medication he receives intravenously on a weekly basis (please refer to the November 2020 IQ for additional background). There are many questions that must be considered in a case like Jose’s. What does it mean when we ask an 8-year-old child to become their own advocate? How can this child question a nurse and other healthcare professionals caring for him or her? How can we help our patients become comfortable advocating for themselves particularly with the implied structural misbalance between the child and the authority? Is this not the same potential problem in both the acute and non-acute setting? Doesn’t this apply to adult patients as well? We can look to our peers, guidelines, and the evidence for answers. One important technique to consider is to integrate Neuro Linguistic Programming (NLP) into our practice. NLP techniques teach us how to incorporate such concepts as: • Thinking affects results • Thinking affects our (subjective) experience
• Use of persuasive language • Using body language • Influencing behavior and eliciting specific responses by use of advanced tools of verbal and non-verbal communications It is important all patients, but especially children, to plan extra time to describe what is happening. It is effective to use pictures and basic pathophysiology concepts that are specific to the patient and are based on individual factors, such as age, cognitive awareness, experiences, and language. There are different ways to explain the function of a port, its location and even the rationale behind flushing protocols. Conversely, explaining the possible negative outcomes when a healthcare professional fails to use proper accepted standard access and maintenance techniques may assist in the patient’s understanding of cause and effect. The goal is for the patient to receive excellent care and preventing undesirable outcomes. Teaching the adult caregiver at the same time as the child allows for a less threatening environment for the child. When the child hears their caregiver asking for clarification on issues, it creates a shared sense of learning and responsibility. Neither are put at the disadvantage of feeling inadequate. This shared learning respects the child’s autonomy, to the extent possible, and empowers the child. Ultimately, the child feels more comfortable asking questions and for help. Each time I see Jose, I reinforce the flush technique by scrubbing the site with the Chloraprep for five seconds or using a circular pattern of scrubbing. I then asking him if that is “ok”? His response now is no; You have to scrub back and forth for 30 seconds. CONTINUED ON NEXT PAGE FEBRUARY 2021 | 22
BEST EXPECTATIONS, WORSE OUTCOMES, CONTINUED FROM PREVIOUS PAGE When I challenge him and explain my expertise as a vascular access nurse, his newest response is, “yes but I am the patient.” Out of the mouth of an eight-year-old comes true advocacy! When it became difficult to aspirate blood from his port and to confirm placement of the Huber needle, I showed Jose and his mother pictures of intraluminal and extraluminal Fibrin buildup. I had suspected a Fibrin Sheath had developed. His port is now four-plus years since placement. Of course, as vascular access specialists, we know Fibrin buildup can develop in minutes not necessarily over years.
Teaching patients how to be their own advocate has been among the priority issues considered by AVA’s Beyond Acute Care SIG. Standardization of care throughout the continuum of care is a hot topic in the United States and around the globe. There is a myriad of regional and organizational differences in practice. Unfortunately, a recent review of standards, recommendations, white papers, and best practice algorithms fails to show consistency in practice procedural instructions for accessing and deaccessing an implanted port. The BACSIG and others continue to pursue standardization of care in the interest of best practice. Here are some examples of differences in the techniques found in various clinical settings when accessing/de-accessing an implanted port: • Outpatient clinics and home infusion companies may or may not consider the action of accessing of an implanted port as a sterile procedure. This is despite the fact that, as vascular access CONTINUED ON NEXT PAGE
I have also taught them to request the qualifications of the nurse caring for him or, for that matter, anyone in their family. Whether in a clinical setting or at home, I explained how national certification from such organizations as the Vascular Access Certification Corporation (VA-BC) and the Infusion Nurses Society (CRNI) validates core foundational knowledge of vascular access, including infusion devices. Certification matters! As Jose’s primary caregiver, Marie has asked questions with which we all are familiar: “but no-one else has done it that way;” and “how come the other floors (acute care facilities) don’t do it that way?” Teaching your patients and their caregivers to be their own advocates is an important part of our professional practice.
23 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER
BACSIG Executive Leadership Monthly Zoom Call
BEST EXPECTATIONS, WORSE OUTCOMES, CONTINUED FROM PREVIOUS PAGE specialists, we know that a PICC/port/central catheter all terminate in the central venous circulation. Established best practice should be consistent regardless of setting because of the same potential for contamination and CRBSI, regardless of type of central venous access? • Some outpatient clinics may not be applying a sterile transparent semipermeable membrane (TSM) dressing on a newly accessed port. Some clinics simply apply a piece of tape over the Huber needle or perhaps a non-sterile gauze with tape over the Huber needle. • Some clinicians simply de-access a port and place an adhesive bandage over the puncture site rather than gauze under a small TSM. Vascular access specialists understand that it takes time for skin closure to occur after the removal of a large bore needle.
• Recently renamed the Beyond Acute Care Special Interest Group (BACSIG), formerly Continuum of Care SIG (CONSIG), is working to identify areas of improvement regarding vascular access found outside of the hospital or acute care setting.
NEXT UP:
In the next part of this series, we will focus on caregiver Marie and the neurologist caring for Jose. They will share their experiences and thoughts on the specifics of Jose’s care, in addition to an ordering physician who practices in a nationally recognized pediatric medical center. The ordering physician will share his thoughts regarding vascular access issues of non-acute care patients who need intravenous services in the home or outpatient clinic setting.
Coming in the Spring 2021 edition of the Journal for Association for Vascular Access:
An Association for Vascular Access Official Position Paper
“Minimum Education and Training for Pediatric and Neonatal IV Insertion for All Clinicians” and competency checklist Read this important information in JAVA first!
FEBRUARY 2021 | 24
WATCH FOR THESE EXCITING CE AND OTHER AVA EVENTS IN THE NEAR FUTURE For more information, check the events calendar at the bottom of avainfo.org, Twitter or Facebook
WEBINAR: A ROADMAP FOR EXPANDING YOUR VASCULAR ACCESS PRACTICE Live: 11 a.m. ET, Feb. 10 (CE Event) Recorded with live Q&A: 8 p.m. ET, Feb. 10 This webinar will explore expanding practice. Including: 1. How scope of practice may limit or ease this transition 2. Steps necessary to expand practice 3. Education Required to expand
SPEAKERS:
REGISTER NOW
Jim Lacy BSN, RN, VA-BC™ Judy Thompson MSNEd., RN, VA-BC™ Amy Bardin Spencer EdD(c),MSc, RRT, VA-BC™ The speakers for this webinar are experts in this area. All have donated their time to create the presentation and to participate in the talk.
COMING SOON TO A DEVICE NEAR YOU: ISAVE THAT … A PODCAST SERIES Fun and conversational, this series will address what you need to know now. Perfect for listing while on the treadmill or waiting in car pool and DMV lines. Live and Available on-demand and non-CE events.
QUARTERLY INDUSTRY ROUNDTABLE Exciting events delivered on popular topics. Join the dialog and get your burning yet practical questions answered directly by the experts (non-CE events)
25 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER
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:
I
Implement insertion care and maintenance bundles
S
Scrupulous hand hygiene
A
Always disinfect every needleless connector
V
Vein Preservation
E
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:
I
Inform us right away
S
See us check your IV often
A
Ask us to clean our hands
V
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.
E
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.
I
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.
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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:
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HAVE YOU BEEN LISTENING? ISAVE That Podcast Season 4 Season 4, Episode 1 Ultrasound-Guided Peripheral IV Insertion: Variability Across Vascular Access Practice
Though ultrasound is the gold standard for guiding peripheral IV insertion, the variability across vascular access practice is extensive. The ISAVE That Podcast returns with a bang in 2021 by welcoming Dr. Nancy Moureau and Dr. Nat Kittisarapong to discuss their recent research on how the inconsistencies in safety products and protocols, variability in the type of gel being used, the cleaning of ultrasound probes and other supplies (and more).
Season 3, Episode 9 Position Paper: Minimum Education and Training for Peds/Neonatal IV Insertion
Timely and successful vascular access can be as challenging as it is vital for the pediatric and neonatal portion of the patient population. In December 2020, the Association for Vascular Access published a position paper titled, “Minimum Education and Training for Pediatric and Neonatal IV Insertion for all Clinicians” to provide recommendations to clinicians performing the most common invasive procedure on the tiniest and most fragile of patients. In this episode of the ISAVE That Podcast, AVA Director of Clinical Education Judy Thompson and Director of Communications Eric Seger discuss the paper with two of its authors, Mary Beth Hovda Davis, MSN, RN, VA-BC™ and Darcy Doellman, MSN, RN, CRNI®, VA-BC™ and then speak with another clinicians about how it could impact their practice. FEBRUARY 2021 | 28
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
Connecting Talent with Opportunity Search and apply for job opportunities in the vascular access field. On LinkedIn? Save time and import your profile directly to the AVA Career Center. Post an ad for an available vascular access position -find the best talent!
Start your search at:
jobs.avainfo.org
Welcome
to our Newest
Members (Joined November 1, 2020 - January 1, 2021)
Rhett Butler -- Calabash, NC
Owen Chambers -- Liverpool, UK
Christopher Cheatham -- Indio, CA
Denise Manzanares -- Sacramento, CA
donna hethcock -- Camarillo, CA
Bethany Ketchale -- Ludlow, MA
Rene Campos Briseno -- Chicago, IL
Christine Ledwidge -- Jackson, MI
Ghafar Kurdieh -- Cooperstown, NY
Genipher Marasigan -- Weymouth, MA
Karen Minard -- Middletown, DE
Luz Caicedo -- Kissimmee, FL
Richard Lanham -- Lemont, IL
Joseph Domen -- Long Beach, CA
Natasha Sullivan -- Salem, OR
Lisa Piccirilli -- Coventry, RI
Fei Yan -- New Hyde Park, NY
Lonny LaBarge -- Colleyville, TX
Alison Sanders -- Mundelein, IL
Samantha Hoffhines -- Temecula, CA
Jacob Schneider -- Diana, TX
Shara Scheys -- Plymouth, MI
Katherine Dacono -- Drexel Hill, PA
Samantha Kendig -- Lancaster, PA
Sarah Drimmel-Stubbs -- Lees Summit, MO
Cynthia English -- Fort Smith, AR
Lisa Xiong -- Sheboygan, WI
Kristina Canaday -- Macon, IL
Kimberly Aguirre -- Wolfforth, TX
Christopher Surmacz -- Katy, TX
Greg Johnson -- Wynnewood, PA
Ashley Kish -- Onsted, MI
Kelly Allerdings-Terry -- Eden Prairie, MN
Cathy Gibbons -- Dublin, Ireland
Lourdes Chavarria -- Fallbrook, CA
Brenda Lane -- Junctions City, OR
nikiya howard -- Ellenwood, GA
Tara Sherburne -- Portland, OR
Marie Morisset -- Ball ground, GA
Christine Romano -- St. Pete Beach, FL
Stacey Gatto -- Lebanon, NH
Jill Hayes -- Indian Head Park, IL
Catherine Cote -- South Porcupine, Canada
Amanda Loe -- Nixa, MO
Lindsay Lawless -- Walnut Creek, CA
Luisa Carey -- Mechanicsville, VA
La’Keysha Johnson -- Winterville, NC
Chantel Allen -- Englewood, FL
Klaus Hoerauf -- Franklin Lakes, NJ
Katarzyna Zajac -- West Dundee, IL
Frances Pennington -- Tega Cay, SC
Gabriela Daza -- Madera, CA
Jamie Perrin -- Alpine, CA
Michael Kevin Corley -- Hendersonville, NC
Sharon Smith -- Canton, MI
Matthew Tackitt -- Walnut Creek, CA
Elizabeth Beach -- San Diego, CA
Elizabeth Castleman -- Colbert, WA
Dynisha Fresneda -- Belle Glade, FL
Karen Phelps -- Canterbury, NH
Marcelete Thompson Young -- Tallahassee, FL
Tammy James -- Little Rock, AR
Ruxel Lumbo -- Hugo, MN
Emily Grupp -- Winthrop, ME
Cyrene Nall -- Pawnee, OK
Rhonda Reynolds -- Austin, TX
Patricia Owen -- SALINE, MI
Caleb Jarratt -- Olathe, KS
Kimberly Manzo -- Plainfield, NJ
Jeoffrey Generoza -- Hanover, MD
Maressa Freitas -- Hyannis, MA
Breea Weisgerber -- Evansville, IN
Russell Acob -- Newark, CA
Tracy Durovec -- Duluth, MN
Lenna Booth -- Scottsbluff, NE
Amy Ensor -- Westminster, MD
Jin Gant -- Oregon City, OR
Cathleen Eckhart -- Irvine, CA
Andrew Seiwert -- Perrysburg, OH
Santiago Boyle -- LaFayette, GA
Bradly Griffin -- Moore, OK
Joven Reyes -- Mebane, NC
Eunah Chang -- Rockville, MD
Faith Banda -- Glenn Heights, TX
Carlos Gutierrez -- Miami, FL
Elizabeth Chingren -- Omaha, NE
Veronica Robbins -- Norman, OK
Deborah Metz -- Shingle Springs, CA
Andre Gremillion -- Robert, LA
Elizabeth Burnett -- Coppell, TX
Maria LaVelle -- Camas, WA
Jenny Secor -- Greenwood, IN
Anna Wojtas -- Philadelphia, PA
Brooke Horinek -- Orlando, OK
Jamie Charous -- Margate City, NJ
Allison McNeil -- Beaverton, OR
Holly Hao -- Santa Clarita, CA
Thomas Deacon -- Ro, MI
Moses Kinyanjui -- Shawnee, KS
Alex Kang -- Whittier, CA
Elizabeth Huberty -- Andover, MN
Vivian Le -- Moore, OK
Sarah Davis -- Tulsa, OK
Peter Christianson -- Silver Spring, MD
Heidi Koranda -- Pinole, CA
Tonja Pool -- Atlanta, TX
Michele Maples -- Thousand Oaks, CA
Shawn Safford -- Hershey, PA
MaryEllen O’Donnell-Edgerton -Manchester, MA
David Rivers -- Sweet Home, OR
Mary Shadders -- Hilton, NY
Andrea Davis -- Morrisville, NC
Ashley Gordon -- Raleigh, NC
Diana Robinson -- Sewickley, PA
Bonita Hughes -- Royal Palm Beach, FL
Vina Vanessa Limpin -- Chula Vista, CA
Lindsey Crites -- Lima, OH
Rachel Cicci -- Morgantown, WV
Lisa Kunz -- Greenland, NH
Kent McCain -- Claremore, OK
Jennifer Styers -- Dallas, TX
Deseree Bailey -- Albuquerque, NM
Brittany Albers -- Metairie, LA
Kenneth Agu -- Newark, DE
Jac-Lyn Perez -- Marion, IN
Shellie Wood -- Cumming, GA
John Newton -- Washington, MO
Chris Carson -- Southington, CT
FEBRUARY 2021 | 30
Watch for the latest from JAVA
Check out our latest edition of:
Have you checked out the Winter 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
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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
Advertise to the Market You’ve Been Looking For . . .
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
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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.
