CVME Insider: Nursing Knowledge That Matters

By Helen Taylor With all of the advancements in infusion technology during the last hundred years, it’s simply astonishing that the IV pole has remained essentially unchanged in design and function during all that time. Top heavy, “tippy”, noisy, awkward, inefficient, for generations the IV pole has been widely viewed as a challenge rather than asset—something to deal with rather than something that actually improves the quality of care. Finally, however, there’s an alternative. The IVEA is transformative patient-care equipment designed by nurses for nurses to improve mobility, safety, efficiency and storability. The IVEA replaces the IV pole bedside and supports the patient during ambulation. It holds all of the patient’s equipment, including infusion bags and pumps, PCAs, oxygen, chest tubes and catheter bag on a stable platform, and moves easily and securely, promoting early and frequent patient mobility. The IVEA’s award-winning design is also unique in that it folds and stores...

Enterovirus D68 (EV-D68) is one of more than 100 non-polio enteroviruses. This virus was first identified in California in 1962. What are the symptoms of EV-D68 infection? EV-D68 can cause mild to severe respiratory illness. Mild symptoms may include fever, runny nose, sneezing, cough, and body and muscle aches. Severe symptoms may include wheezing and difficulty breathing. See  EV-D68 in the U.S., 2014  for details about infections occurring this year. Anyone with respiratory illness should contact their doctor if they are having difficulty breathing or if their symptoms are getting worse. How does the virus spread? Since EV-D68 causes respiratory illness, the virus can be found in an infected person’s respiratory secretions, such as saliva, nasal mucus, or sputum. EV-D68 likely spreads from person to person when an infected person coughs, sneezes, or touches a surface that is then touched by others. What time of the year are people most likely to get inf...

Does Your Hospital Use the  The Surviving Sepsis Campaign ? This c ampaign  was created to help healthcare workers implement the recommended guidelines for Severe Sepsis patients in the Emergency Room (ER) and Intensive Care Units (ICU).  The  Surviving Sepsis Campaign  kits include posters, pocket guides, bundle cards, lapel pins and a list of resources to aid your implementation efforts using the most recent edition of the international sepsis guidelines.   The Surviving Sepsis Campaign has developed pre-packaged kits to help clinicians within institutions to improve sepsis identification, management and treatment.   "The Surviving Sepsis Campaign (SSC) partnered with the Institute for Healthcare  Improvement (IHI) to incorporate its “bundle concept” into the diagnosis and treatment  of patients with severe sepsis and septic shock. We believe that improvement in  the delivery of care should be measured one patient a...

Free ECG Tip Placement Webinar by  International Vascular Access Expert Using x-ray to confirm PICC tip placement wastes clinical care time, exposes patients to harmful radiation, and delays medical therapy. The ECG Tip Confirmation Systems available on the market can help alleviate these problems by using an adult patient's cardiac electrical activity to position the tip of the PICC in close proximity to the cavoatrial junction (CAJ). Final tip location is confirmed by the nurse at the bedside and infusion therapy can begin immediately without the need for a confirmatory chest x-ray. In a clinical study, 99.1% of 114 PICCs were placed at the CAJ or within +/- 1 cm using Bard® Tip Confirmation Technology.   "Rare ECG tip placement webinar by international vascular access expert Mauro Pittiruti of the Università Cattolica del Sacro Cuore in Rome, Italy, is being offered free next month to healthcare professionals, in association with Vygon (UK) Ltd." ...

The CDC 2011 Guidelines for the Prevention of Intravascular Catheter-Related Infections CDC Recommendations In patients not receiving blood, blood products or fat emulsions, replace administration sets that are continuously used, including secondary sets and add-on devices, no more frequently than at 96-hour intervals, [ 177 ] but at least every 7 days [ 178–181 ]. Category IA No recommendation can be made regarding the frequency for replacing intermittently used administration sets. Unresolved issue No recommendation can be made regarding the frequency for replacing needles to access implantable ports. Unresolved issue Replace tubing used to administer blood, blood products, or fat emulsions (those combined with amino acids and glucose in a 3-in-1 admixture or infused separately) within 24 hours of initiating the infusion [ 182–185 ]. Category IB Replace tubing used to administer propofol infusions every 6 or 12 hours, when the vial is changed, per the manufacturer’s r...

  Needleless devices are used for connecting to IV catheters , administration sets, and/or syringes.   They were introduced in the 1990s for the purpose of reducing the risk of needlestick injuries among health care providers.    However, in 2000 the Needlestick Safety and Prevention Act mandated that all employers provider these devices as they have shown to reduce needlestick injuries significantly.   On the other hand; their use has been associated with an increase in complications such as catheter-related bloodstream infection (CRBSI) and catheter lumen occlusion. The reason for these complications are not totally understand and efforts to study their design, user knowledge, poor clinical practices have gotten underway to help reduce or eliminate these complications. The Food and Drug Administration is requiring nine companies to conduct a post market study on positive displacement needleless conne...

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...