The e-news publication of the Association for Vascular Access MAY 2021 | VOLUME XI | ISSUE 2
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
SAVE THE DATE: SEPT. 16-19, 2021
IN THIS ISSUE Page 2
PediNeoSIG: Share to Support
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We’re Back ... In Person!
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D-TEAM Update
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Vascular Access Safety Listed in ECRI Top Ten
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How Are You Doing? Self Care Today and Every Day
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Inside AVA: Notes from the Executive Team
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Prep. Maintain. Protect with Prevantics Brand® advertisement and link
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Tissue Adhesive Bleeding and Oozing Practice Summary
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talkBAC: Best Expectations, Worse Outcomes (Part III)
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Staff Spotlight
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How I Went from “Nay” to “Yay!” on Disinfection Caps
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Four Seasons Project: Continuous Training and Lessons Learned in a Brazilian Hospital
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Welcome to the 2021 Board Development Committee
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AVA Foundation Update
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Network News
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AVA/CVAA Webinar Series
Page 29
Educational Offerings from AVA
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Have You Been Listening? ISAVE That Podcast
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Welcome to Our Newest AVA Members
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For more information on the PediNeoSig and how to join: www.avainfo.org/pedineosig
SHARE TO SUPPORT Mary Beth Hovda Davis | Chair-advisor, PediNeoSIG
Developing your clinical expertise in pediatric and neonatal vascular access can sometimes feel isolating and lonely. Some of us have the benefit of working in robust children’s hospitals with wellestablished vascular access teams, while others may be starting a peds program for the first time or scaling our skill set from adult to pediatrics. Wherever you are in your pediatric/neonatal vascular access journey, the Pediatric Neonatal Special Interest Group (PediNeoSIG) is your resource for support, benchmarking, and networking. Members of the PediNeoSIG come from a variety of institutions all over the world and have a lived experience of developing their skill set and knowledge in this unique and vulnerable patient population. It is through this shared experience that the PediNeoSIG has implemented several conference offerings designed specifically to share our unique cases, complex patients, and lessons learned while advocating for best care for our tiniest and not-so-tiny patients. In the next month there will be a few options to share your experience at our conference. One major opportunity is through our annual PediNeoSIG International Grand Rounds. Please don’t be shy in selecting a patient, a scenario, or a population that you find unique and challenging in your clinical experience. It is through sharing these cases that we collectively learn more about what priorities we need to focus on and what helps us identify next steps when we encounter a similar situation in our own practice. There is an open call for poster presentations due
May 26. We love reading through the great work that has been implemented at a variety of healthcare settings and that focuses specifically on the kids! There is a wide range of topics we are interested in, from improving infection prevention standards, device securement, insertion training practices, developing and sustaining competency, clinical knowledge sharing, and quality improvement work (to name a few). Please take the time to submit an abstract! We all benefit from your contributions. Lastly, our annual Call to Action Award will be reinvigorated this year and is meant to highlight a clinician or institution who has fully embodied and implemented our PediNeoSIG mission.
Please nominate your team, your colleague, your friend or someone who inspires you in their clinical or scholarly work. Every year - but in this year especially - we need to celebrate our work, our dedication and our clinical specialty. Pediatric and Neonatal Vascular Access Clinicians are so important to our healthcare teams and we want to recognize you! Join the SIG for free. Thank you and I look forward to seeing everyone at conference! MAY 2021 | 2
WE’RE BACK . . . IN PERSON! AVA’S ANNUAL SCIENTIFIC MEETING IN THE PREMIER MEETING FOR VASCULAR ACCESS HEALTHCARE PROFESSIONALS. We hope you are as excited as we are to meet faceto-face at the Gaylord Palms in Florida for the AVA Annual Scientific Meeting, September 16-19, 2021 (pre-meeting workshops will be held September 15th). We realize that you may have questions about the safety precautions for this year’s meeting and we want to reassure you that we are keeping in mind guidelines set by the CDC, Gaylord, and the state of Florida. Currently, we are planning for everyone to wear masks, maintain social distancing in the exhibit hall and meeting spaces, and staggering break times between sessions to keep crowd size small. The Gaylord Palms has a multi-pronged approach to meet the health and safety challenges presented by the pandemic. • Face masks are currently required in public areas; • Daily housekeeping services upon request; • Signage throughout to remind guests to maintain social distancing; • Partitions at front desks, concierge stands, and food and beverage service lines; • Hand sanitizing stations for guest use are placed in high traffic areas. As you know guidelines are rapidly changing and we are committed to continually reviewing them as we plan for the safest event for you, our exhibitors, and our staff. While things may look a little different this year with our masks on, the education and networking you have come to count on from the Scientific Meeting will be in full force! Join us for a new session format: Think Tank Sessions. These 90-minute sessions will have 3 to 4 speakers that will engage you as they present on
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topics like: PIVs, Thrombosis, Blood Cultures, Tissue Adhesive, Dressing, Teams and many more! The exhibit hall is filling up as well! While we will be spaced out in the hall, industry representatives are already planning to discuss with you the newest innovations in vascular access. They will be there to answer your questions, demo their products, and provide additional education. The Call for Posters is now OPEN through May 26th so if you have research you would like to share with the attendees at the AVA meeting this year please review poster submission guidelines here. Sixteen posters will be chosen by the AVA Scientific Poster Committee to be included in a Poster Presentation Session taking place on Saturday, September 19th. Are you unable to travel this year? Don’t worry, AVA is planning to have some of the amazing education available for you through a virtual registration option. Preparations are being evaluated to live-stream the General Sessions so that you can watch in real-time and join in the Q&A with the presenters. Select breakout sessions will be recorded so that you can view those on-demand and still obtain continuing education credits. The full schedule of sessions, speakers, pre-meeting workshops, and exhibitors will be released in the coming weeks - be sure to watch your email and social media for more information on how to register. We can’t wait to see you!
D-TEAM UPDATE:
PEDIATRIC AND NEONATAL TOPICS SET FOR 2021 AVA SCIENTIFIC MEETING As we define this new normal, the D-TEAM, which is responsible for planning the annual AVA Scientific Meeting (AVASM), is incredibly excited to plan a safe and engaging in-person meeting! The AVASM content will highlight all of the innovative advancements stemming from the clinical expertise of our fellow pediatric/neonatal vascular access colleagues. New to AVASM are Think Tanks, which are 90-minute sessions showcasing two to four presentations with similar thematic content. Incorporated pediatric and neonatal topics include: tissue adhesives, Blood Cultures: Myth vs.
Fact, vascular access in the neonatal population, and; experiences and outcomes associated with vascular access teams. Additional topics of interest are comprised of difficult intravenous access algorithms, clinical outcomes associated with miniMAGIC, an examination of atypical tip position of central lines on X-Rays, and catheter removal versus salvage in the presence of infection specific to chronic intestinal failure patients. Recognizing the AVA networks have spent the past year largely limited to virtual interaction, we embrace this opportunity to be together once again in September!
SUBMIT HERE POSTER ABSTRACT SUBMISSION AND POSTER DISPLAY GUIDELINES AVA Scientific Posters are a method for authors to present research and/or to display original work. All posters should convey relevance to AVA’s mission, vision and values. The mission of AVA is to lead healthcare by protecting patients and providers to improve lives. Our vision is a world with safe vascular access. Each poster that you would like to display must have a corresponding abstract submitted, by no later than Wednesday, May 26th, through the online Call for Posters. All poster abstract submissions will be notified of acceptance or rejection for digital poster display, and eligibility for Scientific Poster Presentation, by Tuesday, June 21st.
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VASCULAR ACCESS SAFETY LISTED IN ECRI TOP 10 ECRI, the nation’s largest patient safety organization, listed peripheral vascular harm on its Top 10 Patient Safety Concerns for 2021, cautioning healthcare leaders that severe cases of injury and infection can lead to extended lengths of stay and antibiotic treatments—even death. ECRI’s annual Top 10 list helps organizations identify imminent patient safety challenges and offers suggestions and resources for addressing them. This Top 10 report highlights patient safety concerns across the continuum of care because patient safety strategies increasingly focus on collaborating with other provider organizations, community agencies, patients or residents, and family members. Each patient safety concern on this list may affect more than one setting and involve a wide range of personnel.
According to ECRI’s report, the challenge of an effective PIVC harm prevention program is to reduce the rate of PIVC infections as much as possible given a specific patient population. An ECRI and the Institute for Safe Medication Practices Patient Safety Organization (PSO) analysis of 27,320 reports of PIVC events found 6,119 reported infections and 21,201 non-infection all-harm events. ECRI recommends that a multidisciplinary effort involve leadership, those who allocate resources, infection control personnel, vascular access teams, those who insert and remove IVs, and patients themselves. To download ECRI’s Top 10 Patient Safety Concerns for 2021 report for free, visit https://www.ecri.org/ top-10-patient-safety-concerns-2021
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 5 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER To lead healthcare by protecting patients and providers to improve lives
VISION
A world with safe vascular access
HOW ARE YOU DOING? SELF-CARE TODAY AND EVERY DAY Staci Harrison, DNP, RN | 2021-22 Director-at-Large, AVA Board of Directors
When someone asks you “How are you doing?” you may respond, “Great”, “I’m good”, “I’m fine” or “living the dream”. We are finally seeing the light at the end of the pandemic tunnel, however we are not good, great, fine, or living the dream. We, as healthcare workers, are exhausted mentally, physically, socially and spirituality. We are running below a quarter of a tank and yet we keep going. How are you taking care of yourself to take care of others? This is an important question to ponder. We bring our “A” game to work, family, friends, and school, yet we are barely passing when it comes to ourselves. Learn to take care of yourself daily. Here are a few suggestions: • Mentally – spend quiet time with yourself, listening to music, meditate, read/listen to a book, take a break. • Physically – walk, run, do any type of exercise for a minimum of 10 minutes, clean the yard (make it fun), increase your water intake. • Socially – stay connected, have an early meal with an old friend, you can eat outside. • Spiritually – meditate, pray, or practice yoga.
This past year was tough and caused burnout. You are all we have, and if you need refueling, then you must make time to take care of yourself. If we take care of ourselves then we can take care of others. Refuel, reenergize and revitalize your mind, body and spirit. We all rebound differently so do what is best for YOU! While AVA is a multidisciplinary organization, I hope all of you took time to truly celebrate National Nurses Week, May 6-12. Nurses have been among the most important of our pandemic heroes. You deserve to take a break and know this to your core. Bio: 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 Medical-Surgical 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 expectation. Healthcare needs that passion and Staci’s collaborative leadership now more today than ever, and she along with AVA will be there to lead the way.
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INSIDE AVA:
NOTES FROM THE EXECUTIVE TEAM 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. Cate Brennan, MBA, CAE | Chief Executive Officer and Tonya Hutchison, CAE | Chief Operations Officer
VASCULAR ACCESS EDUCATION PARTNERSHIP LAUNCHED! After more than a year in development, the Vascular Access Education (VAE) partnership, featuring the B. Braun Fundamentals of Peripheral Intravenous Vascular Access™ curriculum has moved into the pilot stage and prepares for a full launch in Fall 2021! The VAE Program is open to all current pre-licensure students and the faculty that teach them. The package includes a one-year complimentary student/ faculty AVA membership as well as access to three semesters of peripheral intravascular curriculum. The three-course comprehensive curriculum was developed by vascular access subject matter experts in the United States and internationally without influence from B. Braun. The curriculum will provide vascular access knowledge acquisition through online courses designed to increase the ability of healthcare professionals to insert, care for, and maintain peripheral venous catheters (PIVCs). The curriculum will be offered free-of-charge to pre-licensure associate or baccalaureate academic programs in nursing, medicine, advanced practice, respiratory therapy and other allied health professions. The curriculum was designed to fill a gap in knowledge on the placement, care and maintenance of PIVCs. The curriculum includes three courses: • AVA101, Fundamentals of Peripheral Vascular Access • AVA201, PIV Insertion and Intermediate Concepts • AVA301, Advanced Topics in Peripheral Vascular Access 7 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER
The curriculum includes three pre- and post-tests, student and instructor access to AVA’s learning management platform, periodic reports on student performance to instructor, and student certificate of completion. After passing all three courses, students will receive the AVA Certificate of Completion of Fundamentals of Peripheral Intravenous Vascular Access™ Certificate. AVA believes this certificate of added qualification will be in demand by employers. For more information, please contact avaed@avainfo.org
MINIMUM EDUCATION AND TRAINING FOR PEDIATRIC AND NEONATAL IV INSERTION FOR ALL CLINICIANS The AVA Board of Directors is pleased to announce the publication of its newest position paper, Minimum Education and Training for Pediatric and Neonatal IV Insertion for all Clinicians. The paper was published in the Spring 2021 edition of JAVA. “Healthcare providers caring for pediatric patients require specialized education, training, and competencies for safe delivery of care. Blended learning strategies, which include evidence-based education and hands-on training, have been shown to be effective for initial and ongoing competency assessment. Establishing a vascular access curriculum to include patient assessment, vessel anatomy and physiology, proper device selection, vein selection, appropriate catheter size and length, imaging CONTINUED ON NEXT PAGE
INSIDE AVA, CONTINUED FROM PREVIOUS PAGE modalities, insertion techniques, securement, dressing, and documentation is essential.” Please visit www.avainfo.org/page/PositionPapers to read all current position papers.
devices intended for infusion or phlebotomy, excluding devices intended for monitoring of biomedical therapies, starting with the assessment of the patient and ending with the removal of the device.
NETWORKS
DID YOU KNOW…
On March 16, AVA held a special meeting for network leaders to celebrate moving into 2021 and, hopefully, the soon-to-be post-COVID-19 era. The network representatives and AVA staff had a lively discussion on partnering in 2021, including how to become more multidisciplinary within our memberships.
AVA works in partnership with Infusion Knowledge to provide clinicians the VA-BC™ Exam Preparation Webinar Study Bundle. To purchase the bundle, please visit https://infusionknowledge.com/product/ va-bc-exam-preparation-webinar-study-bundle/
To help achieve these goals, the staff launched a survey to network leaders to identify ways to support growth and success. Working together is especially important as we look forward to meeting AVA’s mission of being truly multidisciplinary. Other discussions included how to work together to deliver continuing education hours for virtual events. “AVA on the Road,” a new program for industry partners, is offered to networks. This traveling webinar allows industry partners to re-broadcast a previously presented webinar at a network meeting. Please contact avainfo@avainfo.org for more information.
CLINICAL PRACTICE GUIDELINES INITIATIVE FORMS TEAMS, STARTS DEEP DIVE The AVA staff is excited to be working with a tremendous group of subject matter experts from around the world for the development of AVA’s first evidence-based Clinical Practice Guidelines (CPG). This initiative is a result of growing interest over the past decade for a standardized framework for healthcare professionals inserting and caring for vascular access devices. The CPG initiative is expected to be a two-year project with most of the work occurring in the first six months. Six teams will meet regularly to discuss and draft the guidelines, align statements with current evidence and research, and decide where a consensus agreement needs to be applied. The project will include all aspects of vascular access
For more info, please email avaed@avainfo.org
WHAT’S IN THE SPRING 2021 JAVA? The Journal of the Association for Vascular Access (JAVA) is a member benefit with free access to articles for all current AVA members. Please visit meridian. allenpress.com/java for more hot articles including: • CE Article: Use of an Evidence-Based Protocol for Repositioning Peripherally Inserted Central Catheters (PICCs) in Children and Adults • Comparison of Patency in 5- and 6-mm Hemodialysis Grafts • Placing a Hemodialysis Catheter in Patients With Multiple Access Failure and Exhausted Usual Approachable Veins: Egyptian Single Center Experience
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MAY 2021 | 8
TISSUE ADHESIVE BLEEDING AND OOZING PRACTICE SUMMARY Lori Kaczmarek, MSN, RN, VA-BC™ | Vascular Access Clinical Specialist, Adhezion Biomedical, LLC
INTRODUCTION Oozing and bleeding at a vascular access insertion site contributes to the device and/or dressing failure. The device failure may be a result of dislodgement or unintentional removal when the dressing or securements fail. The presence of blood or moisture under the dressing requires unscheduled dressing changes adding to an increased risk of catheter-associated bloodstream infections (CABSI).1-3
A STANDARD OF CARE A highly purified medical cyanoacrylate or tissue adhesive (TA) was approved by the United States (US) Food and Drug Administration (FDA) for vascular access (SecurePortIV®, Adhezion Biomedical, LLC, Wyomissing, PA USA) in 2017 and since then has seen increased use to improve vascular access outcomes. While mentioned in the 2016 Infusion Nurse Society (INS) Infusion Therapy Standards of Practice,4 TA was still a “consideration” for its benefit with vascular access (VA) and more research was recommended. The development of a unique cyanoacrylate formula, the expanded use, data collection and published reports propelled TA to become one of four recommended securement technologies in the 2021 INS Standards along with additional recommendations for hemostasis and providing a microbial barrier.1,5
BLEEDING AND OOZING The point of skin penetration for vascular access creates a surgical wound providing a direct route for pathogen entry into the body and 9 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER
an exit site for blood and capillary fluid.6 To control post insertion bleeding, clinicians may resort to using direct manual pressure, use of thrombotic agents, pressure dressings or a combination of interventions. This may lead to frequent or early dressing changes and obscure direct visualization of the insertion point necessary for routine assessment and critical for the prevention of complications.1 7 Use of hemostatic agents or gauze pressure dressings add additional cost, patient, and clinician risk, and require additional time to the care and management of the vascular access device (VAD).2,8,9 Traditional interventions for post insertion bleeding and oozing require additional products or dressings and limit the use or effectiveness of chlorhexidine gluconate (CHG) disks or gel dressings that may be used for microbial protection. Once bleeding and oozing are controlled the patient will require a dressing change (usually within 24 hours) to remove the hemostatic product or soiled gauze and replace with the facility protocol dressing. The manipulation of the VAD and dressing replacement during this process may cause re-bleeding which necessitates yet another cycle of care not to mention additional risk.
HEMOSTATIC EFFECT Cyanoacrylate tissue adhesive formulas have been used for decades in emergency care and surgical arenas and are known for their ability to provide wound hemostasis.5,10 The innovative cyanoacrylate formula approved for VA provides a potent mechanical hemostatic effect and is CONTINUED ON NEXT PAGE
TISSUE ADHESIVE BLEEDING, CONTINUED FROM PREVIOUS PAGE demonstrated to achieve hemostasis 12-fold faster than thromboplastin.11,12 In addition, the proprietary cyanoacrylate formula exhibits antimicrobial activity against gram positive, gram negative, yeast and fungi commonly known to infect VADs.5,13,14
PRACTICE SURVEY To better understand TAs role in promoting hemostasis in VA care and management, a practice survey of clinicians was conducted. The survey tool was created using JotForm (JotForm Inc., San Francisco, CA USA). Forty-four (44) clinicians in US hospitals known to routinely use TA for adult (age greater than 18) VA care were invited to participate. The survey was sent electronically to recipients on February 19, 2021. Twenty-one (21) responses were received before the survey closed on March 27, 2021. Respondent Demographics The title or position of respondents include Vascular Access Specialist (VAS) (13), Director/Manager (5), Clinical Nurse Specialist (CNS) (2), and Infection Preventionist (IP) (1). Most (9) said they learned of TA by attending a professional conference, while 7 received information or a recommendation from a colleague, and 3 found TA while researching product options. Social media, webinars or podcasts, journal advertisements and local professional network events provided other opportunities to learn about TA. Evidence and Target Areas for Improvement When asked on a 1-5 scale (5 highest) if they found enough evidence to support a trial of TA at their facility, 95% (20) responded 4 or 5. Respondents were asked what prompted them to consider TA. They identified bleeding and oozing of lines (19), desire to improve line securement (13), line migration (10), dressing disruption (10), and infection (9). Others (7) included improving dressing adherence, cost savings, improving both patient and clinician experience/ satisfaction, and simplifying care and maintenance as other reasons they chose to implement TA.
Graphic provided by Adhezion Biomedical, LLC
Device Application In this survey, TA is mostly applied to peripherally inserted central catheters (PICC) (20), midlines or long-dwell peripheral intravenous catheters (PIV) (14), central venous catheters (CVC) (8), PIV (4), and arterial line (AL) (3). The VASs in the survey did not report CVC or AL insertions as routine part of their repertoire which may explain lower TA use on those devices. The FDA approved this TA formula for use on CONTINUED ON NEXT PAGE MAY 2021 | 10
TISSUE ADHESIVE BLEEDING, CONTINUED FROM PREVIOUS PAGE Coated or Protected Catheter Use Eight of the 21 respondents replied that they use protected or coated catheters at their facility and shared similar experiences with increased bleeding and oozing relating to their use. One nurse reported that pressure was sometimes held up to 10 minutes to control bleeding. In this patient subset, the clinicians all reported successful or improved hemostasis since the TA was implemented. Protocol Changes all vascular access devices, it has no age restriction, and it is demonstrated to be safe on polyurethane and silicone catheters. 5,15 During their TA trial, most (86%) aimed to reduce unscheduled dressing changes, reduce post-insertion bleeding (76%), and decrease CLABSI (62%). Other target areas were line migration (52%) and improved dressing adherence (42%). Additional comments included the goal to eliminate a dressing change in the first 24 hours, dissatisfaction with previous securement device, and finally skin integrity issues with current products. Clinical Impact • Clinicians were asked how TA impacted their experience with post insertion bleeding and oozing. A summary of responses include: • “Improved a lot. Eliminated frequent dressing changes.” • “We have almost eliminated premature dressing changes and completely removed [hemostatic product] from our process.” • “Decreased dressing change frequency and prevention of accidental migration of catheter during dressing changes.” • “We do not get callback for PICC line oozing.” • “99% of the time we no longer need to place a pressure dressing on patients when they get a PICC or midline.” • “Once I have placed a PICC line and apply the SPIV I place the dressing with the reassurance that the insertion site won’t continue to bleed or need frequent dressing changes.” 11 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER
Asked about any protocol changes made following the implementation of TA, a summary of responses include: • “Currently we are working to eliminate the [CHG disk] from our practice due to the great success of [TA]” • “No longer use sutures on PICC; still use securement dressing but moving to eliminate this soon.” • “All PICC and midlines are protected by [TA] starting with insertion.” • “Eliminated the first 24-hour dressing change.” • “Use [TA] as the first line tool for post-insertion bleeding.” • “We added an additional layer of protection by implementing [TA] to [extended dwell] PIV, midlines, PICCs and pediatric PIVs.” • “Used on every line.” • “We do not use [hemostatic product] anymore.” Improvements Realized Of the 21 survey respondents, 20 reported improvements bleeding/oozing reduction or eliminated, 17 reported decrease in unscheduled dressing changes or early dressing failure, and 16 commented about the clinician satisfaction. Other improvements realized included improved patient/ parent satisfaction, ease of dressing change care and management, and improved insertion site visualization. CONTINUED ON NEXT PAGE
TISSUE ADHESIVE BLEEDING, CONTINUED FROM PREVIOUS PAGE Referring to a Colleague Using a 1-5 scale (5 highest) regarding education and implementation, 95% (20) rated the ease by which they were able to educate caregivers/clinicians to use TA a 4 or 5. The clinicians surveyed were asked what they would tell another colleague who asked if they should consider adding TA to their practice. The responses include: • “Great product, easy application, cost effective.” • “This is a must-have in your toolbox.” • “[TA] is very easy to use and works very well.” • “Take the opportunity to initiate a 14-day trial. Make sure you have pre and post metrics to compare…and the outcomes will speak for themselves.” • “It will definitely benefit the patient.” • “I would highly recommend the use of the TA. I use it on all my PICC line placements to assist with infection prevention and movement of the catheter. I feel I have added another level of protection for my patient.” • “A small amount of the TA applied to the insertion site will go a long way. The need for pressure dressings, thrombolytic patch is not needed as long as you use the TA at the insertion point.” • “Absolutely one of the best products moves we have done.” • “It will change your practice for the better!”
SUMMARY Graphic provided by Adhezion Biomedical, LLC
No Adverse Events No adverse events or skin issues were reported by the respondents. Fifteen (15) additional comments were added reflecting that they rarely if ever use adhesive remover in this adult population. When used, the facility’s currently stocked adhesive remover [pad] would be allowed to sit over the insertion site for 10-15 seconds to saturate the area where adhesive is present. This action is sufficient to gently wipe and remove glue residue.
Post insertion bleeding and oozing at the vascular access insertion point contributes to negative patient outcomes. Frequent dressing changes expose clinicians to potentially infectious blood and body fluid and add bloodstream infection risk, patient discomfort, and increase cost through use of additional supplies and clinician time. The use of an innovative highly purified cyanoacrylate TA at the point of catheter insertion provides a potent mechanical hemostatic effect. Additional benefits CONTINUED ON NEXT PAGE MAY 2021 | 12
TISSUE ADHESIVE BLEEDING, CONTINUED FROM PREVIOUS PAGE include sealing the insertion site and preventing microbial invasion at the skin-catheter tract. TA secures the catheter and can also be applied under the dressing to improve dressing adherence. These added benefits simplify care and maintenance of vascular access devices. Using one product for all VA devices which targets multiple care points (i.e., securement, bleeding and oozing, microbial barrier) can improve clinician competency and improve consistency in use and application.
REFERENCES 1. Gorski LA, Hadaway L, Hagle ME, et al. Infusion Therapy Standards of Practice, 8th Edition. J Infus Nurs. Jan-Feb 01 2021;44(1S Suppl 1):S1-S224. doi:10.1097/ NAN.0000000000000396 2. Timsit J, Bouadma L, Ruckly S, et al. Dressing disruption is a major risk factor for catheter-related infections. Crit Care Med. Jun 2012;40(6):1707-14. doi:10.1097/CCM.0b013e31824e0d46 3. Association for Vascular Access (AVA). Resource Guide for Vascular Access: Recommended Study Guide for Vascular Access Board Certification. vol 3. 2019:148. 4. Gorski L, Hadaway L, Hagle M, McGodrick M, Orr M, Doellman D. Infusion therapy standards of practice. Journal of Infusion Nursing. 2016;39 (suppl 1):S1-159. 5. Adhezion Biomedical LLC. SecurePortIV: Indication for Use (IFU). SPI-IFU01-1903. June 2019. Accessed April 14, 2021. www.SPIVTraining.com 6. Moureau NL. Vessel Health and Preservation: The Right Approach for Vascular Access. vol 1. Springer International Publishing; 2019. 7. Corley A, Ullman AJ, Mihala G, Ray-Barruel G, Alexandrou E, Rickard CM. Peripheral intravenous catheter dressing and securement practice is associated with site complications and suboptimal dressing integrity: A secondary analysis of 40,637 catheters. Int J Nurs Stud. Dec 2019;100:103409. doi:10.1016/j. ijnurstu.2019.103409 8. Palm MD, Altman JS. Topical hemostatic agents: a review. Dermatol Surg. Apr 2008;34(4):431-45. doi:10.1111/j.1524-4725.2007.34090.x 9. Moureau N. Impact and Safety Associated with Accidental Dislodgement of Vascular Access Devices: A Survey of Professions, Settings, and Devices. Journal of
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the Association for Vascular Access. 2018;23(4):203-215. doi:10.1016/j.java.2018.07.002 10. DeAnda A, Jr., Elefteriades JA, Hasaniya NW, Lattouf OM, Lazzara RR. Improving outcomes through the use of surgical sealants for anastomotic sealing during cardiovascular surgery. J Card Surg. May-Jun 2009;24(3):325-33. doi:10.1111/j.15408191.2009.00809.x 11. Guido A, Zhang S, Yang C, Pook L. An innovative cyanoacrylate device developed to improve the current standard of care for intravascular catheter securement. J Vasc Access. Sep 9 2019:1129729819872881. doi:10.1177/1129729819872881 12. Zhang S, Guido AR, Jones RG, Curry BJ, Burke AS, Blaisdell ME. Experimental study on the hemostatic effect of cyanoacrylate intended for catheter securement. J Vasc Access. Jan 2019;20(1):79-86. doi:10.1177/1129729818779702 13. Prince D, Kohan K, Solanki Z, et al. Immobilization and Death of Bacteria by Flora Seal® Microbial Sealant. International Journal of Pharmaceutical Science Invention. 2017;6(6):45-49. 14. Prince D, Solanki Z, Varughese R, Mastej J, Prince D. Antibacterial effect and proposed mechanism of action of a topical surgical adhesive. Am J Infect Control. Jan 2018;46(1):26-29. doi:10.1016/j.ajic.2017.07.008 15. Di Puccio F, Giacomarro D, Mattei L, Pittiruti M, Scoppettuolo G. Experimental study on the chemicophysical 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
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.
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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)
MAY 2021 | 14
talkBAC BEST EXPECTATIONS, WORSE OUTCOMES (PART III) 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 and February 2021 IQ - Names changed for privacy I spoke directly with Jose’s neurologist, let’s call him Dr. Noble, who works at a large metropolitan children’s hospital. His specialty is Duchenne Muscular Dystrophy. Thanks to my training, learned knowledge from certification and hands-on participation in pre-conference skills workshops, I was able to explain my concerns regarding Jose’s malfunctioning port. This experience gave me the tools to justify why I felt Jose required a dye study to confirm location of the catheter tip termination, device patency, and the possibility of a vessel stricture near the lumen of the catheter. Dr. Noble quickly expressed his lack of knowledge when it came to implanted ports and problem solving when one is not functioning correctly. I assured him that I was knowledgeable. This brought up an issue that deserves discussion: the physician had never met me and had no knowledge of the VA-BC™ certification and what it means. When I explained my clinical expertise and steps I had taken to ascertain what I felt was the problem, the physician could only defer to the interventional radiologist as the only expert he had experience with… not a nurse or respiratory therapist! As part of leadership in our newly renamed BACSIG (Beyond Acute Care Special Interest Group), this encounter shows the need to educate physician-partners in the specialized certifications and continuing education 15 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER
provided by both the AVA and the INS. We need to educate other healthcare professionals on the skills of VA specialists and how we assist them in caring for patients. Back to the story: Dr. Noble agreed to the dye study but results were inconclusive. There was no indication of fibrin buildup either intraluminally or externally on the catheter tip. He spoke with a thoracic surgeon who convinced him that a port exchange was warranted. Upon removal of the old port, we saw a large section of the septum seal was missing and, therefore, the answer to many malfunctions was now explained. Thanks to AVA’s continuing education over the years, I had a seat at the table with problem identification, intervention and on-going monitoring of Jose’s new adult port. As a note of importance: the surgeon listened to my suggestions as to incision location and other techniques, including use of cyanoacrylates rather than sutures.
MOM’S IMPRESSIONS During this process, Jose’s vague symptoms surrounding a defective port were ignored as were those of his mother, Marie. Epigastric discomfort requiring intermittent calcium carbonate and slow infusion became unnecessary with his new port. Access difficulty was resolved by the surgeon with CONTINUED ON NEXT PAGE
BEST EXPECTATIONS, WORSE OUTCOMES, CONTINUED FROM PREVIOUS PAGE selection of a port with suture-base stabilization, placed at my request. The neurologist now listens to Marie’s feedback and impressions with more credibility. In addition, the process has given Marie better understanding of correct procedures and some best practices, allowing her to be an even more effective caregiver for her son; she is now asking more questions before procedures are performed. Jose has also become a better advocate for himself, asking more questions about his port and the procedures being performed, whether in-hospital or at home.
DR. NOBLE’S IMPRESSIONS Dr. Noble reports he is seeing a disturbing trend occurring in home infusion, one which he feels has direct impact on patient care. He has no idea why or what the justifications are for the change but, as a stakeholder, he is concerned. In what he terms “the traditional model,” nurses worked for home infusion companies providing patient care, medication, and supplies. The field nurse communicated directly with the physician or their designated representative. If a patient had questions, they could put a request in for the field nurse to call back. Now, things appear to have changed. The current model now seems focused on specialty pharmacies contracting with nationwide staffing or pool agencies as designated by the Joint Commission. These companies provide nursing services only. All supplies, medications, and pumps, if applicable, come from the pharmacy and NOT the staffing agency, representing a significant deviation from the conventional pharmacy model practiced throughout the United States. Dr. Noble has seen large pharmaceutical companies contract with these staffing-only agencies and, apparently, they have policies in place that prohibit
field nurses from initiating phone calls or having any communication with the provider directly. The “field nurses” must call their office, relay the information to a clinical coordinator, who then relays information to the pharmacy representative (who could be a pharmacist or pharmacy technician) who is not providing direct patient care. Dr. Noble stated that even if he requests a call from the field nurse some agencies must go through the pharmacy staff first. This can delay notification of patient changes and affects the care his patients receive.
CONCLUSIONS Jose is doing well and his new port is working perfectly. He no longer has any GI issues related to his infusions and he remembers “scrub the hub” every time - with the correct scrub times! The issues brought up by this case show the wide gaps in vascular access care across the country which hinders the application of consistently high standards of practice throughout the continuum of care. If you work in post-acute care and are interested in sharing your passion for vascular access and wish to make positive change happen, please contact us at BAGSIG@avainfo.org to become part of the BACSIG family. We welcome your feedback and thoughts regarding this series. Our dedicated section of IQ, titled talkBAC, is your place to bring up ideas, questions, suggestions, and tips on the practice and application of vascular access best practices.
JOIN THE BACSIG Joining BACSIG is your pathway to knowledge. No matter what your specialty within the continuum of care, vascular access is a part of that specialty. Enhance your knowledge and stay current in practice by multidisciplinary participation and engagement at all levels from novice to expert. MAY 2021 | 16
STAFF SPOTLIGHT J. BLAKE HOTCHKISS BSN, RN, CCRN, CRNI, VA-BC™ POSITION AT AVA: Clinical Education Specialist SUPPORT SYSTEM: My girlfriend, our children, our families. FAVORITE MOVIE: I’m more of a Netflix or Hulu series binge watcher. But if I had to pick a movie, Shawshank Redemption was one of my favorite movies growing up. It’s also based in my home state of Maine. FAVORITE QUOTE: “When you were made a leader you weren’t given a crown, you were given the responsibility to bring out the best in others.” -Jack Welch MY ESCAPE: Going back to my childhood home on the coast of Maine. Always feels good to work on the old homestead and enjoy the tranquility of a place that is so far removed from the hustle and bustle of my everyday life. FAVORITE CITY: Harborside, ME (AKA “the coast”) MY ROOTS: Born in Maine, raised in western Pennsylvania, then college and adult life in Maine. My father was a college professor and swimming/ diving coach. My mother is a genealogist and American history expert specializing in the Revolutionary War. This is where my strong work ethic, passion for research and academia, and love of nostalgia originate from. WHAT DO YOU ENJOY ABOUT WORKING FOR AVA: My favorite thing is networking with my much larger family of colleagues (that’s all of you!). We are all “vascular access nerds” and have a unique personality compared to the rest of healthcare. I love being able to connect with my people and learn how similar we are in our passions for patient safety and care. Wherever you are in your journey with vascular access, I want to learn, and I want to help. WHAT DO YOU DO AT AVA: I work in the AVA Education Department and support the many volunteers that give their time. This includes hosting webinars, podcasts, and other outlets for knowledge sharing within our community and beyond. I am the staff liaison for the PediNeoSIG and the BacSIG, supporting their hard work in improving best practice. My other duties include managing projects like the development of the clinical practice guidelines and other current and future education products. WHAT ARE YOUR GOALS AT AVA: First is innovation. I want to take the mission and vision of AVA to places it has never been before. Second is growing the reach of the AVA and best practices in vascular access. We have a duty as specialists to support and educate in the generalist model of device insertion and maintenance. The objective is to shape and guide clinical practice so that it is safer for all patients. I ask myself, “How can I help others? How can I remove barriers? How can I help clinicians make a difference for their patients wherever they work?” Let me know… I’m happy to help. 17 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER
HOW I WENT FROM “NAY” TO “YAY!” ON DISINFECTION CAPS Jill Nolte, BS BSN CRNI VA-BC™
I will admit it – I was a hold out on disinfection caps. In my former opinion, if we taught clinicians to correctly scrub connections with alcohol wipes there was no need to spend money on disinfection caps. Turns out I was completely wrong! For my part, the function and purpose of a cap was not well understood. Knowledge is power and here is the reason my opinion changed. Recently, it was my privilege to prepare and deliver a presentation on disinfection caps for an AVA webinar. The process of learning about the issues, products, and rationale all led to a new belief regarding these bright little wonders. We did not have or use disinfection caps in the not-so-distant past. For many of us, these caps simply appeared on our nursing units. The entirety of education provided was “here, put these on your connectors” with no further explanation. No one really told us why we were being asked to add yet another task to our day. So let’s consider the “why”. Previously, we had needle injection ports on our lines. The port was disinfected with alcohol and then a sterile needle was used to infuse therapy. It worked well; infection risk was not the problem of focus but accidental disconnection and needlestick injuries were. To reduce these issues, we moved to split septum systems using blunt plastic infusion devices.
and lots to store. Split septum devices were known to leak and the surface had to be disinfected – not always an easy thing to do with some designs. Innovation took us to the next device, needleless connectors, the seemingly perfect fix: easy access, no needles, less “stuff” to provide infusions. But needleless connectors brought a new problem – intraluminal infection. Pathogens are literally infused directly into the patient’s blood stream through contaminated ports. “But we scrub our ports with alcohol,” the clinician defends. “Is that enough,” I ask? Needleless connectors vary and have varying instructions for use (IFUs). Scrub time and friction force vary widely from clinician to clinician. Several disinfectant solutions are used to clean ports, each with different dry times. We currently do not have clear guidelines for active disinfecting technique. What we do have is a lot of variance and a need to focus on preventing CLABSI during the care and maintenance portion of the catheter dwell. This can CONTINUED ON NEXT PAGE
The split septum systems solved the needlestick injury issue somewhat, but not completely as needles were still used to penetrate the septum. Some of the devices were a challenge to flush clean. There were supply chain issues, too, with lots to stock MAY 2021 | 18
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.
HOW I WENT FROM “NAY” TO “YAY!”, CONTINUED FROM PREVIOUS PAGE be improved with eliminating variability through the utilization of disinfection caps, an effective, passive disinfection option. An abundance of studies support use of disinfection caps and governing bodies (see references) support their use. Caps are easy to use, easy to incorporate into patient care routines, and are proven effective in reducing CLABSI. Needleless connectors brought us safety from sharps injuries, but the tradeoff may have been an increased risk of intraluminal infection; disinfection caps mitigate these risks. So: grab a cap and protect the patient! Disclosures: Employed by Medline Industries, LLC, distributor of Swabflush
REFERENCES: INS: Infusion Nurses Association: “Perform passive disinfection by applying a cap or covering containing a disinfectant agent (eg, 70% isopropyl alcohol, iodinated alcohol) to create a physical barrier to contamination between uses. Follow manufacturers’ directions for use regarding time for effectiveness after attachment and the maximum length of effectiveness” Gorski, L., Hadaway, L., Hagle, M., Broadhurst, D., Clare, S., & Kleidon, T. et al. (2021). Infusion Therapy Standards of Practice, 8th Edition. Retrieved 9 March 2021. SHEA: Society for Healthcare Epidemiology of America (SHEA) 2014 Update: “Use an antiseptic-containing hub/ connector cap/port protector to cover connectors.” Strategies to Prevent Central-Line Associated Bloodstream Infections in Acute Care Hospitals. Society for Healthcare Epidemiology of America (SHEA) 2014.
19 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER
FOUR SEASONS PROJECT –
CONTINUOUS TRAINING AND LESSONS LEARNED IN A BRAZILIAN HOSPITAL
Cláudia Cândido da Luz. RN Nurse. Coordinator of the Infusional Therapy Team (TTI) Hospital Israelita Albert Einstein. Jorge Luis Saraiva dos Santos. RN Nurse. Member of the Infusional Therapy Team (TTI) Hospital Israelita Albert Einstein. Claudia Regina Laselva. RN Nurse. MsC. Director of Hospital Israelita Albert Einstein. Alexandra do Rosario Toniolo. RN Nurse. MsC. Specialist in hospital infection control of Hospital Israelita Albert Einstein. Ellen Cristina Bergamasco. RN Nurse. MSC. PhD. Professor in Faculdade Israelita de Ciências da Saúde Albert Einstein.
One of the biggest challenges for the prevention of infections related to health care is keeping the multidisciplinary care team continuously trained. Many studies have reported difficulties in keeping staff engaged in infection control measures, including measures to prevent Central LineAssociated Bloodstream Infection (CLABSI). The U.S. Centers for Disease Control and Prevention (CDC) suggests that instituted training programs should be continuous and systematic; although the guidance is clear, it is increasingly difficult to put it into practice. In hospital services, training is related to new protocols, new products, admission training for new employees, training related to adverse events, or periodic training; in general they are led by a specific area that works with the development of professionals. Hospitals with large number of beds and, consequently healthcare professionals, have specific sectors for development of employees and typically organize training by teams, making it difficult to look at the specific care with central catheter and CLABSI-prevention measures. At the Hospital Israelita Albert Einstein, located in the city of São Paulo (Brazil), 682 beds are available. The training is organized by a corporate team that inserts into its annual timeline activities related to the prevention of bloodstream infection. The historical rate of Central Line-Associated Bloodstream Infection (CLABSI) was approximately 1.4 percent per month until 2011. In 2012, the hospital created the Infusional Therapy
Team (TTI). It consists of nurses, who are responsible for the insertion and maintenance of peripherally inserted central catheters. The nurses also responsible for improving the success rates in peripheral punctures, reducing the incidence of chemical phlebitis, reducing pain related to peripheral puncture, ensuring early removal central venous catheters, and acting to reduce bloodstream infection rates related to intravascular devices. In addition to the professional development of the TTI members, the institution proposed the creation of care protocols and monitoring of patients with implanted catheters. During their activities, TTI realized the need for specific training on the care of implanted catheters, which would happen continuously and systematically. TTI found that training should be extended to the entire multidisciplinary team assisting patients, which included approximately 4,000 professionals, including: physicians, nurses, physiotherapists, and psychologists and, among others. This is how the 4 Seasons Project was created. The construction of the 4 Seasons Project was based on the premise that continuous training can improve patient safety by providing quality care andreducing CLABSI. The project was named 4 Seasons because the training occurred quarterly with the seasons (Spring, Summer, Fall and Winter). CONTINUED ON NEXT PAGE MAY 2021 | 20
HOW I WENT FROM NAY TO YAY, CONTINUED FROM PREVIOUS PAGE The training programs invariably use playful strategies. Some of the training occurred in the inpatient and patient care units, where healthcare professionals are most frequently stationed. But the training also occurred in unusual settings like the cafeteria, auditorium, hallways, elevator hall, and other locations around the hospital. The main objectives of the 4 Seasons Project are to promote discussion of infection prevention initiatives and to reinforce hand hygiene in the maintenance of the venous catheter. A goal was to initiate changes in attitudes and behaviors of healthcare professionals regarding the care provided. Although the central focus is the multiprofessional team, the actions seek to involve patients, caregivers, and family members as it is believed that self-care should be encouraged to aid in prevent infection. In the eight years of the project, many strategies have already been used, such as a “card game championship,” “button soccer game,” “sticker album,” “memory game,” “trial-simulated jury,” among others (Figure 1); all strategies, with no exception, replace the rules and guidelines of the original activities with information related to hand hygiene and infection prevention. The strategies last for three months, and they choose a specific theme, for example “Everyone in action, zero infection.” At the end of each season, all healthcare professionals of the institution are invited to a celebration of the results obtained and the completion of another stage of the training. In addition to playful strategies, the 4 Seasons Project seeks to certify professionals in good practices in handling catheters. Hand hygiene, disinfection of connectors, and flushing with swirling, and positive pressure are important pillars within this certification. Certified professionals receive the Golden Seal to be attached to their identification badge (Figure 2). Annually, 98 percent of nursing professionals are validated (approximately 2,300 people). In order to encourage nursing staff to continue adherence to good practices, professionals with the best care performance are identified in each area. These 21 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER
individuals then participate in a high-fidelity clinical simulation scenario with a case related to the topics discussed during the year. After participation, the winners are recognized prominently in the institution’s digital media and are awarded trophies and prize vouchers. The training results showed an 81.8 percent reduction in the historical rate of CLABSI, in which we have an average in 2019 of 0.24 per 1,000 central line-days and at times reaching 0 per 1,000 central line-days. It was observed that the reduction in CLABSI directly impacted the reduction of hospital bed turnover time because it was noticed that patients with catheters implanted and monitored by TTI are discharged early since they do not have infections. In addition to reducing the infection rate and turning the bed, it was realized that the 4 Seasons Project is sustainable and ensures the continuity of training, which results in a change of behavior and improves the provision of patient care. In 2020, despite all the adaptations and impacts caused by the pandemic, TTI remained active and performed the insertion and monitoring of patients with implanted catheters, in addition to the training of Project 4 Seasons. Corresponding Author: Ellen Cristina Bergamasco. RN Nurse. PhD. Professor in Faculdade Israelita de Ciências da Saúde Albert Einstein. Address: Rua Antonio Júlio dos Santos, 201, bloco 5 apto 11. Fazenda Morumbi. São Paulo – São Paulo. Brazil. E-mail: ellen.bergamasco@einstein.br E-mail: ellenbergamasco@gmail.com Fone: +5511982492219
All authors should have made substantial contributions to all of the following: (1) The conception and design of the study, or acquisition of data, or analysis and interpretation of data - Claudia Cândido Luz and Jorge Luis Saraiva dos Santos (2) Drafting the article or revising it critically for important intellectual content - Claudia Cândido Luz, Jorge Luis Saraiva dos Santos, Claudia Regina Laselva, Alexandra do Rosario Toniolo and Ellen Cristina Bergamasco
WELCOME TO THE 2021 BOARD DEVELOPMENT COMMITTEE! Kristin Jacobs, MSN, MBA, RN, VA-BC™
The Board Development Committee (BDC) is one of the AVA’s most important committees. The BDC is responsible for: 1) developing and recommending a slate of officers and Directors at Large (DL) to the AVA Board of Directors for its approval; 2) reviewing candidates for the AVA Foundation Board positions; and 3) filling open BDC positions. Candidates for both boards and the BDC are reviewed for how individuals can support and fulfill the organizations’ missions and strategic plans. These factors are used to guide the BDC in candidate selection. The Committee currently has 11 members and 5 have begun their service in 2021 (below in alphabetical order by last name):
MICHELE BISCOSSI, ACNP-CS, MS, RN, CNL, VA-BC™ Michele is an Acute Care Nurse Practitioner and Clinical Nurse Leader in Interventional Radiology at Albany Stratton VA Medical Center in Albany, New York. She has been a member of the AVA for 14 years and has served on itsBoard of Directors. She co-authored the AVA Resource Guide for Vascular Access: AVA’s Recommended Study Guide for Vascular Access Board Certification and was the National Task Force Leader of the AVA Vein Health and Preservation Early Assessment Tool.
DARCY DOELLMAN, MSN, RN, CRNI, VA-BC™ Darcy is the Clinical Manager for the Vascular Access Team at Cincinnati Children’s Hospital. Darcy was the lead author of the “Pediatric CVC Maintenance Bundles” and co-author of the 2016 Infusion Therapy Standards of Practice. Her research on pediatric vascular access care is widely published in prominent peer-reviewed journals.
LORI KACZMAREK, MSN, RN, VA-BC™ Lori has joined the BDC as the AVA Board Liaison and is the current AVA Presidential Advisor. She has had previous leadership roles with the American Association of Critical Care Nurses (AACN) and was also Past President of a local chapter of the Greater Milwaukee Area AACN (GMAC-AACN). She has also served as a Director-at-Large for the AVA.
CONTINUED ON NEXT PAGE MAY 2021 | 22
WELCOME TO THE 2021 BDC, CONTINUED FROM PREVIOUS PAGE SANDRA MEHNER, RN, VA-BC™ Sandra spent the past 21 years of her nursing career specializing in vascular access. She was the Vascular Access Team Manager at Tampa General Hospital, the Tampa Bay area’s only research and academic Level 1 trauma center. She then traveled throughout Florida placing PICCs and midlines but found her home providing vascular access care to cancer patients at Moffitt Cancer Center for the past seven years. She has been the Secretary/Treasurer of GulfVAN for more than 10 years.
NADINE NAKAZAWA, RN, BSN, VA-BC™ Nadine is a vascular access clinician on the Vascular Access Team at Stanford Health Care in California and has been a nurse for more than 40 years. Nadine was President of the Association of Vascular Access (AVA) from 2008-09 and served on the AVA Board of Directors for five years. She has been an active member of AVA since its founding in 1985 and a member of INS since the mid-90s. In 2011, she was the chair of the group writing the first ever AVA Resource Guide for Vascular Access: AVA’s Recommended Study Guide for Vascular Access Board Certification.
CONTINUING 2021 MEMBERS ARE: Kristin Jacobs, 2021 Chair Mark Hunter, 2022 Chair-Elect Marcia Ryder, AVA Foundation Liaison Bryan Davis Sean Lau Andrea Owens As the BDC Chair, I have found participating in the BDC gratifying and it has enriched my viewpoint of the AVA. Being a committee member allows me to contribute to the future of the AVA and assist with moving its strategic plan forward within our communities. If you would like to be considered for the AVA Board, the AVA Foundation Board or the BDC, please submit your leadership application by clicking here: https://form.jotform.com/70575425872968
23 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER
UPDATE FROM THE AVA FOUNDATION
FOR PATIENT SAFETY AND CLINICIAN EDUCATION Amy Bardin-Spencer, Ed.D, MSc, RRT, VA-BC™
With deep gratitude, we thank Marcia Ryder, PhD, MS, RN, FNAP, outgoing AVA Foundation (AVAF) President for her work and as she moves into a two-year term as Presidential Advisor. Amy BardinSpencer, Ed.D, MSc, RRT, VA-BC™ will become president in May. We believe that transitions are important times to provide updates on the work of the AVAF. For the past year, the board of directors has been laserfocused on rebuilding the Foundation for a greater purpose, starting with the recruitment of highly connected, committed, and capable board members. The Foundation has developed a new vision, mission, and core beliefs. This laid the groundwork for an innovative strategy to establish multidisciplinary approaches to prevent vascular access patient harm “The Board and staff have worked tirelessly and well beyond the committed time to reorganize
the infrastructure of the Foundation, provide administrative support to its functions, outreach to explore partnerships and alliances, and share knowledge and passion for patient safety,” said Ryder. “I am grateful for the leadership of Dr. Ryder and the AVAF Board over the past year,” said Bardin-Spencer. “I look forward to guiding the AVAF forward and building on the strategic vision and mission.” We are proud to have recruited seven new board members, who represent a multidisciplinary group of advanced practitioners, each with diverse specialized areas of expertise and perspective. (Meet them on page 22.) The AVAF has established several committees that include: Budget and Planning, Bylaws and Policy, and Fundraising; an Industry Task Force was also formed to assess potential benefits to the specialty. Each group is working to ensure alignment with AVA, the founding organization of AVAF, and supporting the developmental needs for initiatives.
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 MAY 2021 | 24
NETWORK NEWS AVACNY Jan Elliott
AVACNY was proud to have Jack LeDonne, MD, VA-BC™, FACS, share a presentation on the “Quality Improvement in Vascular Access: Is the Dressing Just a Dressing?” for our first Central New York webinar on April 22, sponsored by Eloquest Healthcare. Thank you to Eloquest and team for always supporting our Networks. We appreciate the continuing education your team provides. Dr. LeDonne’s presentation sparked a lot of interest with our members actively participating in the discussion and chats. Many shared their own experiences dealing with different “sticky” situations and adherence to dressing integrity. Several practice points and product availability were discussed to improve catheter outcomes and create favorable dressing change methods for skin integrity and securement. We were blessed to have our officers together for this event to plan our 2021 goals with ongoing education through webinars and in-person presentations.
Founder Suzanne Herbst was available to join us and give her expertise and input on network challenges and how best to move forward after a pandemic. Plans are underway and she will be presenting on the history of the AVA and its roots at the 12th Annual AVACNY Infusion Therapy & Vascular Access Teaching Day Symposium in November.
Standing from left: Jennifer Lemon, Courtney Davaiu, Rick Simpson, Jennifer Smith. Seated from left: Jan Elliott, Suzanne Herbst (AVA Founder) and Jill Holland.
We are looking forward to another excellent educational event in Syracuse. For more information about what is going on with AVACNY, visit us online at avacny.com
GULFVAN GulfVAN has partnered with FLAVAN to continue virtual meetings for 2021. Kay Coulter from Infusion Knowledge Inc. presented “Infusion Risks Related to Implanted Venous Ports” in April. This presentation was supplemented with case studies from network members. GulfVAN plans to keep its meetings virtual until we are able to book group meetings at our local hospital again.
25 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER
NETWORK NEWS FLAVAN Diana Melton, MSHA, RN, CRNI, VA-BC™ | FLAVAN President Meagan Capen, CPNP-AC, MSN,VA-BC™ | FLAVAN President-Elect Caitlin Soldati, BSN, RN, VA-BC™ | FLAVAN Secretary Crystal Penna BSN, RN, | FLAVAN Treasurer
FLAVAN has continued to collaborate with GulfVAN to provide live Webinars for our members! In February we covered Best Practices in Ultrasound Reprocessing, March provided a much needed WorkLife Balance informative hour, and April discussed Infusion Risks with Implanted Central Venous Access Devices! Our members are enjoying learning at home, but are hopeful for future in person meetings! We have 3 more webinars planned for the second half of this year!
The majority of FLAVAN’s BOD attended the encouraging and informative AVA Network Leadership Meeting in March! We are ALL looking forward to the annual AVA Scientific Meeting in our home SUNSHINE State of Florida in September 2021! For more FLAVAN news and upcoming events please visit our website by clicking the link FLAVAN and don’t forget to like us on Facebook!
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 MAY 2021 | 26
Beyond Doing: Using Data to Advance your Practice (and Be your Patient’s Advocate) Trying to convince your colleague to change their practice, your manager to invest in new technology, your institution that PICCs are not the source of all blood stream infections? Want to showcase your practice, your productivity, your outcomes? Start collecting data. Not only is it recommended in standards and guidelines that influence our practice, it is the best way to improve quality in your practice. Learning objectives: • Review current evidence-based documents regarding Vascular Access and Infusion Therapy specific to data management and quality improvement • Describe the use of internal clinical use data bases to demonstrate value and identify opportunities for improvement • Understand the relationship between research and quality improvement
Tuesday June 8, 2021
Chellie DeVries MPH, CIC, VA-BC™
2:00pm ET / 11:00am PT
REGISTER HERE avainfo.org / cvaa.info
Sheryl McDiarmid RN, BScN, MEd, MBA, AOCN, ACNP, CRNI(C), CVAA(c)
Provider approved by the California Board of Registered Nursing provider Number CEP12371 for 1.0 contact hour 27 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER
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!
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
MARKETING & COMMUNICATIONS MANAGER
MEMBER & NETWORK MANAGER
cbrennan@avainfo.org
kmaisel@avainfo.org
jlivsey@avainfo.org
NAEL MHAISSEN, MD
AVA STAFF CATE BRENNAN, MBA, CAE
CHIEF OPERATIONS OFFICER
TONYA HUTCHISON, CAE thutchison@avainfo.org
KAYCE A. MAISEL
CLINICAL EDUCATION SPECIALIST
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
MAY 2021 | 28
Educational Offerings from AVA
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
29 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER
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
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
AVA/CVAA WEBINAR: BEYOND DOING: USING DATA TO ADVANCE YOUR PRACTICE (AND BE YOUR PATIENT’S ADVOCATE) Trying to convince your colleague to change their practice, your manager to invest in new technology, your institution that PICCs are not the source of all blood stream infections? Want to showcase your practice, your productivity, your outcomes? Start collecting data. Not only is it recommended in standards and guidelines that influence our practice, it is the best way to improve quality in your practice.
REGISTER NOW
Live: 2 p.m. ET, Tuesday, June 8 (CE Event) See the ad for this event on page 27
SPEAKERS: Chellie DeVries, MPH, CIC, VA-BC™ Sheryl McDiarmid, RN, BScN, MEd, MBA, AOCN, ACNP, CRNI(C), CVAA(c)
Provider approved by the California Board of Registered Nursing provider Number CEP12371 for 1.0 contact hour
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 VIRTUAL 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)
31 | 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.
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 Season 4, Episode 3 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™ 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™ 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.
Season 4, Episode 2 Vascular Access Implications in Patients with Renal Disease In the practice of vascular access, renal disease is a very sticky subject when it comes to site and device selection. In this episode of the I Save that Podcast series, Dr. Michael Serle DMSc, MS, PA-C a practicing Physician Assistant in Interventional Radiology and Tonja Stevens BSN, RN, VA-BC™ AVA Board of Directors Member and AVA President-Elect take our listeners on a deep dive into the current guidance and best practices for vascular access. You can check us out on any of your favorite podcast platforms.
MAY 2021 | 34
Welcome
to our Newest
Gail Cantrell -- Jackson, SC Laura Adams -- Cleveland, TN Brad Huit -- Portland, OR David Langton -- Smithville, MO Susan Zagula -- Cleveland, OH Leimomi Holmes -- Fayetteville, GA Gregory Reisinger -- Sarasota, FL Michael Headington -- Yuma, AZ Michaela Lewis -- Virginia Beach, VA Matthew Milewski -- New York, NY Kelly Sexton -- Ocala, FL Victoria Castelli -- Terrace Park, OH Michele Quinonez -- Spring Hill, FL Holly Gade -- Monee, IL Maria Grace Funcion -- Henderson, NV Benjamin Maguire -- Chicago, IL Jasmine Rudman -- Portland, OR Kevin Harvey -- Mt. Juliet, TN Jacob Jacoby -- Silver City, NC Jeremiah Riel -- Summerville, SC Alma Keesling -- Alachua, FL Ricardo Espinosa -- Grapevine, TX Alison Gilliland -- Grafton, NH Marypat DeRosa -- Forked River, NJ Eric Wilson -- Oxford, NC Yuki Kawai -- Orange, CA Connor Di Corcia -- Washington, DC Jacque Collins -- Wasilla, AK Laci Danner -- Vernon, TX Ann Weinstock -- San Francisco, CA Kimberly Burran -- Kennard, TX Bernice Lolio -- The Woodlands, TX Paul Terronez -- Denton, TX Jestin Jose -- West Roxbury, MA Heidi Garcia -- Janesville, WI Valentina Adnane -- Chicago, IL Kathy Moore -- Olympia, WA Ana Jay -- Chicago, IL Lacey Johnson -- Woodland, WA William Ryland -- Vacaville, CA Raleigh Davis -- Longs, SC Patricia Sisson -- Port Orchard, WA Kambrel Dunn -- Blackfoot, ID Kandace Ellington -- Henderson, NC Samantha Pros -- Lees Summit, MO Jessica Wells -- Apex, NC Amanda Mendelis -- Culver City, CA Rashmee KC -- Olympia, WA Norma Elizabeth Patton -- Edinburg, TX Sokny Prom -- aberdeen, WA Kaye Belport -- San antonio, TX Jennifer Driscoll -- Mooresville, NC Carlos Ramirez -- Enfield, NH Mark Nolan -- Sweet Springs, MO Richard Blevins -- Piney Flats, TN MaVictoriaJoy Lopez -- Garden City Park, NY Archie Williams -- Ojai, CA Vicky Jobin -- Flushing, MI
Rosalena Livers -- Lincoln, NE Aryn Goetsch -- Aledo, TX Sheila Mighty -- Dallas, TX Ashley Pyle -- Midland, TX Bradley Weirauch -- Wauseon, OH Erin Simco -- Mineola, NY Tara Cross-Ziegler -- Cape Coral, FL Brooks Palmer -- Spartanburg, SC Natalie Kitamura -- Pearl City, HI Tammi Dowling -- Tecumseh, MI Debbie Terrell -- Toccoa, GA Ash Morgan -- Mission, KS Jennifer Schwartz -- DAVENPORT, FL Mandy Holt -- Mount Vernon, OH Joley Kramer -- Billings, MT Courtney Roland -- Confluence, PA Nayades Alfonso -- Miami, FL Margaret Diller -- Parkton, MD Dana Hebert -- Beaumont, TX Taylor Dickinson -- Norman, OK Sadie Wills -- New Orleans, LA Heather Wood -- Pittsburgh, PA Kimberly Wagner -- Alexandria, LA Shay Longhurst -- Pocatello, ID Heidi Kelleher -- Bloomington, IL Montgomery Moore -- Somerset, KY Daniel Donnelly. -- Pittsburgh, PA Jessica East -- Choctaw, OK Patricia Morton -- Midlothian, VA Jane Hodson -- Gillingham, UK Wendy Baldwin -- Swartz Creek, MI Aaron Seppanen -- Howell, MI William Foster -- Grand Blanc, MI Courtney Stempfer -- Richmond, TX Elizabeth Werda -- Flint, MI Gabrielle Klaus-Heinlein -- Alsip, IL Maria Sedano Aguado -- Alcobendas, Spain Alice Hadgraft -- Colchester, UK Louis Trujillo -- Bonita, CA David Jungck -- Cheyenne, WY Judith Czerniak -- Grants Pass, OR Daniel Garcia -- Glen Rock, NJ Christopher Osterbauer -- Ellsworth, ME Wendy Gregory -- Verdi, NV Katherine Zak -- Orchard Park, NY Cameron Bird -- Trenton, ME Donna Solberg -- Rogers, MN Barbara Meyer -- Port Orange, FL Kay Sams -- St Petersburg, FL Jeff Chase -- Monmouth, ME julianne cramer -- Minneapolis, MN Deborah Ayers -- Broken Arrow, OK Keri Bannister -- Erie, CO Joseph Lauffer -- Moseley, VA Donald Williams -- BEAVER, PA Maria Hagan -- Milan, MI Sarah Perez -- Anaheim Hills, CA Zachary Hahn -- North Little Rock, AR
®
Caleb Heatherly -- Miami, OK Aleksandra Ward -- Pocomoke, MD Colleen Passariello -- Revere, MA Scott Barker -- Port Charlotte, FL Janelle Roberts -- Yorba Linda, CA Alicia Patten -- White River Jct, VT Atsuko Forrest -- Forest, VA Elisa Volk -- Hampton, MN David Moss -- Burleson, TX Maryam Soomro -- Berwick, AUS Kurt Knecht -- Newtown, PA Christian McGowan -- Lewiston, ME Sara Alain -- Morrisville, NC Juan Macias -- Laredo, TX Geraldine Greif -- Broken Arrow, OK Melissa Falowski -- Jupiter, FL Emily Barcelo -- Kew Gardens, NY Lawannah Ann Cumby -- Cookeville, TN Patricia LaBrecque -- Grand Blanc, MI Adelaide Sit -- San Lorenzo, CA Brian Mondragon Jones -- Milwaukee, WI Alexander Jimenez -- Houston, TX Don DuVan -- Clarkston, MI William Drew -- Gilford, NH Elena Bezdenezhnykh -- Wilmette, IL Amy Fitch -- Foley, MN Dana Jones -- Henderson, NC Gayleen Sorensen -- Pocatello, ID Christine Garten -- Minneapolis, MN Samantha Nicolson -- Darwin, AUS Marilyn Nelson -- Davison, MI Yue Cong -- Changchun city, China Amy Sarli -- Bedford, MA Jon Altamira -- Canyon Country, CA Chip Knapp -- Lawrence, KS Shawn Yim -- Otsego, MN Renae Crow -- Columbia, MO Sara Nabozny -- Livonia, MI Breland Frith -- Canton, GA Kari Cattaneo -- Fort Wayne, IN Stephanie Purcell -- Quinton, VA Gayla Clearman -- Rowlett, TX Chris Merio -- NEWARK, DE Anna Allen -- Pittsburgh, PA Robert Laraway -- Tilton, NH Loreli De Fina -- Chicago, IL Marci Yarbrough -- Fostoria, OH Dana Mirra -- Bensalem, PA Patti Tomb -- Omaha, NE Hilary Chandler -- Houston, TX Leon Surrao -- Stevenson Ranch, CA David Craig-Smith -- Los Angeles, CA Brian Church -- San Francisco, CA Lisa Davis -- Belmont, NC Andrea Brown -- Blue point, NY mary farmer -- jacksonville, FL Anna Kolliou -- Aberfeldie, AUS Wilma Robert -- Waterford, NY
35 | IQ | INTRAVASCULAR QUARTERLY NEWSLETTER
Members (Joined January 1 - April 30, 2021)
Shane Barrett -- Lugoff, SC Stephan Smith -- Round Rock, TX Kathleen Smith Walker -- East Meadow, NY Russell deJong -- New River, AZ April Moslen -- Athens, AL Melisa Fink -- Pearland, TX Preksha Patel -- Des Plaines, IL Susan Paulson -- Broomfield, CO Patricia Spoto -- Mattydale, NY Susan Nelson -- Saint Peters, MO Valerie Sothcott -- Roanoke, VA Marilyn Ann Daniel -- Bellingham, WA Diane Moehring -- Wasilla, AK Kimberley Smith -- Hudson Falls, NY Ashley Godbey -- Beaver, WV Jedediah Gervacio -- Baltimore, MD Irene Galang -- Salinas, CA Robert Dragoo -- Corsicana, TX Stacy Selby -- Mounds, OK Jaime Makela -- Beaverton, MI Ashley Mans -- Houston, TX Nicki Cupp -- Clinton, MO Lauren Schneider -- Boca Raton, FL Marilyn Leyton -- Wellington, FL Deborah Gerber -- Minneapolis, MN Wanda Bullock -- Austin, AR Brianne Steele -- Cumberland Foreside, ME Russel Carson -- Naperville, IL Frances Rono -- Harrisburg, PA Anne Gill -- Norcross, GA Adrianne Roddy -- Wylie, TX Jared Thames -- Bainbridge, GA Alex Seiler -- Erlanger, KY Melissa Langford -- Rockwall, TX Erik Thomsen -- Pleasanton, CA David Martin -- Louisville, KY Claudia Kennedy -- Hunt Valley, MD Vicki Polaski -- New Eagle, PA Joyce Clay -- Bloomington, IL Donya Davis -- Jacksonville, FL Rosemary Pastva -- Collegeview, PA Tiera Jones -- Puyallup, WA Diana Dowdall -- Buffalo, NY Ashley Colberg -- Maple Grove, MN Robert Perret -- Saltillo, MS Setegn Deressa -- silver spring, MD Stephanie Ceralde -- Lake in the Hills, IL Kayce Maisel -- Atlanta, GA Coni Rickley-Anthony -- Loveland, CO Katie Donnelly -- Brownsville, WI Kimberly Carlisle -- Cumming, GA Laura Interian -- River, NJ Andrea Owens -- Indianapolis, IN William Duong -- Monterey Park, CA Krizia Morales -- Carolina, PR
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
00
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?
Visit our website www.avainfo.org
@associationforvascularaccess www.facebook.com/associationforvascularaccess/
@ISaveThatLine twitter.com/ISaveThatLine
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 Copyright © 2021 Association for Vascular Access. All rights reserved.
@i_save_that_line www.instagram.com/i_save_that_line/
@associationforvascularaccess www.pinterest.com/associationforvascularaccess/
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.
