• Celia Wells, Ziya Zhang, Christy Chan, Amy Brito, and Roopa Kohli-Seth.
• Celia Wells is senior director of nursing for critical care, Icahn School of Medicine at Mount Sinai, New York, New York.
• Am. J. Crit. Care. 2021 Jul 1; 30 (4): 295-301.

BackgroundMore than 1 billion peripheral vascular access devices are inserted annually worldwide with potential complications including infection, thrombosis, and vasculature damage. Vasculature damage can necessitate the use of central catheters, which carry additional risks such as central catheter-associated bloodstream infections. To address these concerns, one institution used expert nurses and a consult request system with algorithms embedded in the electronic medical record.ObjectivesTo develop a uniform process for catheter insertion by means of a peripheral vascular access service dedicated to selecting, placing, and maintaining all inpatient peripheral catheters outside of the intensive care units.MethodsDescriptive analysis and χ2 analysis were done to describe the impact of the peripheral vascular access service.ResultsIn 2018, 6246 consults were reviewed. Of these, 26% did not require vascular access. Similarly, in 2019, 7861 consults were reviewed, and 35.3% did not require vascular access. Use of central catheters decreased from 21% in 2017 to 17% in 2018 and 2019.ConclusionsThe peripheral vascular access service allowed patients to receive appropriate peripheral vascular access devices and avoid unnecessary peripheral catheter placements. This may have preserved patients' peripheral vasculature and thus prevented premature central catheter placement and contributed to an overall decrease in central catheter days. With the peripheral vascular access service, peripheral vascular access devices were selected, placed, and maintained by experts with a standardized process that promoted a culture of quality and patient safety.© 2021 American Association of Critical-Care Nurses.

13 keywords...

hide…