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Professional Day 2019: Evidence-Based Approaches to Care in Pediatrics and Obstetrics Professional Day 2019: Evidence-Based Approaches to Care in Pediatrics and Obstetrics

Professional Day 2019: Evidence-Based Approaches to Care in Pediatrics and Obstetrics - PowerPoint Presentation

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Professional Day 2019: Evidence-Based Approaches to Care in Pediatrics and Obstetrics - PPT Presentation

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

cme activity continuing cne activity cme cne continuing peripheral texas education hospital catheter content interest contact hours nurses success

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Slide1

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.

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The Superheroes of IV AccessLindsey Zaremba BSN, RN, CPN, CPHONImelda Mercado-Nuda BSN, RN, VA-BC

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Vascular Access

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Failed IV attempts

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Ultrasound Guided Peripheral (USG) IV

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Vessel 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

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Vessel Assessment

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Picture of U/S image

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Site Selection

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Challenges

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Is it the right line?

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What the highest concentration of Dextrose for Peripheral IV?

12.5%

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Complications: Insertion is only the beginning of the journey

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Bedside staffInfiltrations can be more severe. MEASURE PIVIE and refer to Extravasation/Infiltration Table for further management

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Training

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Clinical staff had first time success rate of 18-86% but VAT can achieve 98-99% first time success.

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Metrics

Since October 2018

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MetricsOver 3,010 Patient Encounters

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Saved attemptsVAT team has an average 1.09 attempts success rate

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Metrics

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Metrics

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ReferencesMoureau. (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