Troubleshooting Vascular Access Device Selection

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Bryan College of Health Sciences
Purpose: To educate registered nurses (RN) regarding the necessity for pre-assessment of risk factors, and importance of vascular access device (VAD) selection. Will providing this education to RNs, improve understanding of appropriate VAD selection? Literature Review: Identified knowledge gaps and patients presenting with co-morbidities and associated risk factors are affecting VAD selection, leading to inappropriate prescriptions from providers. Central lines (CL) are associated with central line associated bloodstream infections (CLABSI), leading to increased morbidity/mortality rates. Even with national initiatives created to improve safety and education regarding VAD selection, CLABSIs are still occurring. Three factors leading to complications with VADs (host factors, device factors, and provider factors) have been identified. Mandatory annual training on maintenance of VAD improves confidence and competence. The Plan, Do, Study, Act (PDSA) cycle provides a framework for developing, testing, implementing change and improvement in VAD selection. Methods: The setting for the QI project was general/progressive/critical care areas in an urban hospital. Project stakeholders were a Clinical Educator, and a Clinical Nurse Specialist. The RNs on selected units were given comprehensive VAD education on pre-assessment of risk factors, and importance of appropriate VAD selection. The participants completed a pre-test, and then completed a post-test following education, to determine understanding. The data were reviewed and analyzed. IRB reviewed the project and deemed it a quality improvement project. Results: The project question was supported by the outcomes, as evidence by, improved post education scores. It was determined that the location of the education session can be detrimental to the learning outcomes. Future testing considerations would include review of test question verbiage to be more succinct and unit directed. Conclusion: VAD selection education improved the knowledge of the RNs regarding appropriate VAD selection. Plan to disseminate education to all units, and commit to implementing annual education.
Troubleshooting, Vascular access device selection
Badura, N., & Beil, L. (2020). Troubleshooting vascular access device selection [MSN Capstone presentation]. Lincoln, NE: Bryan College of Health Sciences.

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