Provided by Texas Childrens Hospital September 19 th 2019 Houston TX 800 CONTINUING NURSING PROFESSIONAL DEV ELOPMENT Texas Childrens Hospital is an approved provider with commendation of continuing nursing education by the Texas Nurses Association Approver an accredited appr ID: 814897
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Professional Day 2019: Evidence-Based Approaches to Care in Pediatrics and ObstetricsProvided by Texas Children’s Hospital September 19th, 2019 | Houston, TX | 8:00
CONTINUING NURSING PROFESSIONAL DEV ELOPMENTTexas Children's Hospital is an approved provider with commendation of continuing nursing education by the Texas Nurses Association - Approver, an accredited approver with distinction, by the American Nurses Credentialing Center’s Commission on Accreditation. REQUIREMENTS FOR SUCCESSFUL COMPLETIONTo receive contact hours for this continuing education activity, the participant must: Sign in to the activity Attend at least one session (contact hours awarded based on attendance)Complete the post evaluationOnce successful completion has been verified, a “Certificate of Successful Completion” will be awarded for up to 8.0 contact hours. For web link issues, email cne@texaschildrens.org
CONTINUING MEDICAL EDUCATION (CME) ACCREDITATION
Texas Children’s Hospital (TCH) is accredited by the Texas Medical Association to provide continuing medical education for physicians. CREDIT DESIGNATIONTexas Children’s Hospital designates this live activity for a maximum of 8.0 AMA PRA Category 1 Credits TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. CME transcripts available upon request via email: cme@texaschildrens.org
LEARNING OUTCOME: At the completion of this activity the learner will be able to enhance quality care and patient outcomes through evidence-based inter-professional practice in the area of pediatrics and obstetrics.
CONFLICTS OF INTEREST
The planning committee members/content reviewers and/or presenters of this CME/CNE activity have disclosed
NO
relevant financial relationships related to the planning or implementation of this CME/CNE activity: Eric Williams, MD, Amanda Garey, Angie Rangel, Deborah Lee, Jessica Ramirez, Jill
Stonesifer
, Kathryn Holl, Lauren Ivanhoe, and Lindsey Zaremba
The following speakers of this CME/CNE activity have disclosed the following relevant financial relationships related to
this CME/CNE
activity.
Those conflicts of interest have been appropriately resolved
:
Carla Giannoni, MD – Formal Advisor, EPIC Pediatric Otolaryngology Steer Board
Jeff Wagner – Formal Advisor,
Omnicell
Advisory Board
The activity’s director/Nurse Planner has determined that no one who has the ability to control the content of this CME/CNE activity – planning committee members and presenters/authors/content reviewers – has a conflict of interest.
Slide2The Superheroes of IV AccessLindsey Zaremba BSN, RN, CPN, CPHONImelda Mercado-Nuda BSN, RN, VA-BC
Slide3Vascular Access
Slide4Failed IV attempts
Slide5Ultrasound Guided Peripheral (USG) IV
Slide6Vessel AssessmentPre-considerationsPast surgeriesComorbid conditionsThrombosisAnatomy (tortuous veins, bifurcations)Technical ConsiderationsOptimal USG peripheral IV site is in a vein 2-4 mm in diameter or larger and 0.3-1.5 cm in depthVein size determining catheter size. Bigger not always better. Goal is smallest catheter!Recommended USG catheter length 2-6 cm
Slide7Vessel Assessment
Slide8Picture of U/S image
Slide9Site Selection
Slide10Slide11Challenges
Slide12Is it the right line?
Slide13What the highest concentration of Dextrose for Peripheral IV?
12.5%
Slide14Complications: Insertion is only the beginning of the journey
Slide15Bedside staffInfiltrations can be more severe. MEASURE PIVIE and refer to Extravasation/Infiltration Table for further management
Slide16Training
Slide17Clinical staff had first time success rate of 18-86% but VAT can achieve 98-99% first time success.
Slide18Metrics
Since October 2018
Slide19MetricsOver 3,010 Patient Encounters
Slide20Saved attemptsVAT team has an average 1.09 attempts success rate
Slide21Metrics
Slide22Metrics
Slide23ReferencesMoureau. (2019). Vessel Health and Preservation: The Right Approach for Vascular Access. Springer International PublishingEdwards, C., & Jones, J. (2018). Development and Implementation of an Ultrasound-Guided Peripheral Intravenous Catheter Program for Emergency Nurses. JEN: Journal of Emergency Nursing, 44(1), 33–36. https://doi.org/10.1016/j.jen.2017.07.009