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Infusion Therapy: 5 Things Nurses Should Know About CVAD’s   Central Venous Access Devices (CVAD's)   First the nurse must know what a CVAD is and where it will be placed in the patient.  A CVAD is a Central Venous Access Device.  This may be a PICC line , Triple lumen , Groshong , or other type of centrally located vascular access device.  CVAD’s are an essential part of Infusion Therapy and the nurse must learn and understand the differences in the types and locations of the devices as well as the infusates that will be administered through the devices. The following are 5 important topics that Nurses should be aware in relationship to their CVAD: 1.  Nurses must get an order for a chest  XRAY or use an alternative device to confirm Placement of the Distal Tip of the CVAD The distal tip of the PICC line is best positioned in the Lower one thoird of the SVC 2.  Ensure that if using a CVAD that the health care team and fac...

How Things Have Changed Over the past two years I have taught a lot of students; both RN and LVN's.  I have taught in the classroom and on the job.  I have seen a lot of new equipment that has made our lives easy; however, this is so simple and I dumb founded that I did not think of it.  Before the BD Autogard Insyte and the B. Braun Introcan angiocatheter devices; we used straight 18 gauge and 20 gauge over-the-catheter needles without any safety device.  There were not even safety shields.  We were taught to stick the patient and throw the needle away immediately.  We were to have the sharps container at the bedside or with close reach so you could dispose of the needle promptly.  However, statistics have shown us that this was not good practice and that as professionals we still left needles lying around or threw them in the trash by accident.  Then the CDC and NIOSH decided to enact the 2001 Needlestick Safety Act t...

This year the Association for Vascular Access (AVA) celebrated its 25th Anniversary in San Jose, CA.  The AVA plus the Infusion Nurses Society equal a perfect marriage for infusion therapy as well a good thing for patients and health care professionals alike.   The AVA Scientific Meeting was a great experience and it provided a great deal of information as well as a preview of future technology in Infusion Therapy and Vascular Access . During this years meeting there were several nurses that presented their stories in regards to blood exposure from attempting to gain a vascular access device or blood for lab values.  The following are some of those health care workers . Cheryll, BSN, RN, OCN Edie, BSN, RN, Emergency/Trauma Healthcare personnel are at risk for blood exposure from bloodborne pathogens, that include hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodefi ciency virus (HIV). Exposures may occur through needl...

Vascular Access Devices Think about this for a while; at any given time; more than half to three quarters of all patients receive some form of intravenous care or medication during their hospital stay.  Intravenous therapy can range from normal saline to total parenteral nutrition, chemotherapy, electrolytes, antibiotics, narcotics or a combination of these parenteral therapies. Nurses are currently infusing several hundred various types of medications, intravenous solutions , and/or blood products.  Patient venous access may vary from poor vascular integrity, poor circulation, good vascular integrity, and excellent blood flow or a combination of each the aforementioned. Nurses must have a good understanding of why everyday peripheral intravenous therapy fails.   It is often that the characteristics of the intravenous medications and/or solutions provided to the patient and through their given vascular access device that the primary factor venous acc...

CHLORA-PREP   ™ for infection Control Every year, a lot of lives are lost due to the spread of infections in hospitals. Health care workers can take precautions to prevent the spread of infectious diseases. This is a vital part of nursing and as patient advocates it is our duty to follow these steps as a part of infection control. Proper hand washing is the single most effective method to prevent the spread of infections in our hospitals. If you were a patient or one of your family members was a patient would you not be concerned then? Don't be afraid to remind friends, family and other health care providers to wash their hands before getting close, performing a procedure, or touching the patient before starting an IV. DONT FORGET Cover the coughs and sneezes Using gloves, masks and protective clothing Making tissues and hand cleaners available to everyone Following hospital policies and procedures when working with paitents in regards to bloo...

Remember the days in the Intensive Care Unit (ICU) when giving patient Mucomyst to help break up that thick , yucky, stuff?  Or working in the emergency room (ER) and maybe the night shift receives an aecatminophen overdose.  They would pull out the Mucomyst and give the patient some orally to help protect the liver. Mucomyst USES: can be give by inhalation, acetylcysteine is used to help thin and loosen mucus in the airways due to certain lung diseases (such as emphysema, bronchitis, cystic fibrosis, pneumonia). This effect helps you to clear the mucus from your lungs so that you can breath easier. May also be given by mouth (orally), used to prevent liver damage from acetaminophen overdose. Working in the Emergency room (ER), nurses must be familiar with intravenous medications. One medication that stands out is intravenous (IV) Acetadote .  This medication is also given orally for acetaminophen overdose as well; however, oral medications can take l...

Over the past two to three decades we have really grown in the health care industry in the fact that we have developed and advanced the infusion and vascular therapy industry by leaps and bounds with the PICC line, Mid-line, and peripheral intravenous catheters.  However, as nurses we have not kept us with the pace of technology in regards to our education and skills sets.  This may seem harsh yet numbers do not lie and with this in mind it is a simple fix.  Practice, Practice, Practice. Still many years later we continue to have one in four medications errors in our hospitals as well as approximately 45 000-164 000 1 patients get an infection in their central venous access devices (CVAD).  ( CDC.gov ) Most of the infections in our patients CVAD ’ s occur the intensive care units ( ICU ) .   Who is responsible for these infections and errors? We are as nurses.  Whether you are a new graduate nurse or a nurse with a lot of experience i...

Nurses have long been charged with caring for patients in different settings.  Some work in the ICU, ER, LTC, or even doctors’ offices.  What is so puzzling is that some nurses seem to fail to realize that no matter what setting they are in; a patient is still a patient.  Standard procedures, tasks, skills, and critical thinking do not change much from area to area.  Granted there are more advanced skill sets and the need for higher critical thinking in the specialty areas; however, if the nurse will remember the “5 Medication Administration Rights.” As well as the fact that every patient may at some point need the nurse to perform life saving skills such as cardiopulmonary resuscitation (CPR).  Rule #1:  DON’T PANIC  If you Panic you will forget everything that you have learned and the patient will suffer. A senior investigator with the Department of Consumer Affairs testified at a hearing on a complaint that the board of registered...