CVME Insider: Nursing Knowledge That Matters

3.8 million central venous catheters (CVCs).... 2 million peripherally inserted central catheters (PICCs)..... and 310 million peripheral intravenous devices sold yearly in the US......   "Based on average salary and benefits for an RN, the average time of 36 minutes for a nurse to trouble shoot and restart a PIV translates to a labor cost of an estimated $22.79 per incident ( Rosenthal, 2005 )."   Vascular access and Infusion Therapy  is clearly a high priority and nurses take a lot of time performing these procedures for our patients. Getting the right vascular access device placed early in the hospital stay can speed treatment and patient discharge while minimizing cost as well as restarts.   Maintaining the health of our patients veins and arteries has become an important issue as patients now come to hospitals more acutely ill, living longer, often having chronic conditions. According to the Centers for Disease Control (CDC) selection of the...

  A Huber Needle is a specially designed hollow needle used with implanted ports. A Huber needle has a long, beveled tip that is inserted through the patients skin as well until it accesses the silicone septum the implanted port's reservoir. The beveled tip of a Huber needle will not remove a core of silicone from implanted port as this is the way it is designed.   This design will allow as much as 2000 needle sticks into the implanted port’s reservoir without having to be changed. Dr. Ralph L. Huber , a dentist, designed the sharp, beveled, directional needle tip and Dr. Edward B. Tuohy, an anesthesiologist, refined it for use in spinal catheters. Huber needles are used to access ports implanted under the skin of patients who may be suffering from a chronic illness, such as cancer, pancreatitis, or has the need for repeated access to veins for blood withdrawal.   These patients often need the implanted port for infusion of medication , nutritional solutions, blo...

  Protect Against It Yahoo news report “The Law Offices of Kenneth A. Wilhelm uses expert testimony to prove medical negligence in the case of a day-old infant who suffered permanent injuries as a result of improper IV administration. The Law Offices of Kenneth A. Wilhelm, a New York personal injury law firm, has successfully obtained an $800,000 verdict on behalf of their client, a day-old infant, who suffered permanent scarring and injury Extravasation malpractice case: Law firm secures $800,000 verdict. The child was admitted to the Montefiore Medical Center in the Bronx on Jan. 13, 2006, a day after he was born. The law firm filed a complaint in the Supreme Court of the State of New York, Bronx County (Index # 8785/2007) against the hospital alleging that the child, who was scheduled to undergo spina bifida surgery the following day, was not properly monitored by nurses at the hospital while he was receiving intravenous fluid in preparation for the sur...

Medical personnel automatically think of CPR when it comes to the saying Look! Listen! & Feel! However, they should also think about Infusion therapy as well. So many times nursing staff attempt to perform an IV catheter on a patient and without fail they do not succeed on the first time.  Why does this happen? Many times the nurse looks for the vein and fails to listen to the patient and fails to feel for the vein.  It is very important to not attempt an IV Catheter on the first look.  Every patient has a vein; however, sometimes those veins may be hard, they may take a curve, or even stop short of what they appear to be at first glance.  Learning your patients anatomy can help save their veins and help you as a medical professional become more successful in your infusion therapy skill. Look  When looking for a vein on your patient; try and look for the most straight vein. Do not just stick the first vein you see.  Look at ev...

If you have drawn blood or started IV's for any length of time; one knows that you cannot be vain when it comes to your patients veins Veins will collapse or shrink or blow; due to many reasons within our control and some beyond our control. If the provider does not prepare the patient and keep the patient calm the patient may panic. If the provider does not use the right equipment samples will hemolyze. Parents who may be scared will not hold their children and the kids will kick. Difficult venipunctures are simply a part of the everyday task that every nurse working may face. If you think that your day will be perfect every day you come to work and draw blood or start an IV then you are vain. There are so many different patients, illnesses, and other factors that will play into your success at drawing blood or starting your infusion therapy . Drawing blood from drug addicts, obese people, critically ill patients, geriatric patients, and pediatric patients will...

IV Fluid Resuscitation The human body is composed of different fluid compartments and each compartment is important in regards to fluid resuscitation; however, each compartment must work in cohesion with the other. Our bodies are made up of mostly water; and water is the key source of life. However, if the water in our bodies is not distributed correctly it can have a detrimental impact on the patient’s outcome. The fluid compartments consist of the Intracellular Fluid Compartment (ICF), the Extracellular Fluid Compartment (ECF), the intravascular space, and the interstitial space. The Intracellular Fluid Compartment contains about two-thirds of the body’s total fluid or 66% according to the manual of Critical Care; whereas the Extracellular compartment consists of one-third or 33% our total fluid. The Extracellular compartment may be broken down further into the intravascular space and interstitial spaces. The intravascular space contains approximately 25% and the...

Did you know that as nurses we perform over 300 million peripheral IV's in America every year?  This is a lot of IV starts especially if you think about how many people exist in America.  That is nearly one IV for every American. How do nurses learn to perform IV Therapy ?  New graduates nurses get little to no hands on training or exposure to IV Therapy in nursing school and thus makes them ill-prepared once they get onto the floor. There is a lot of controversy over how to teach student nurses on the Art and Science of inserting an intravenous catheter. There have been studies that have proven that computer-based training produces a more successful outcome versus the traditional hands on training of peer-to-peer groups or the use of mannequin arms. The Infusion Nurses Standards of Practice also discourages the use of peer-to-peer practice as well.  The problem with this issue is that the computer based programs can cost up to $12,000 and not every bus...