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...

Subphrenic abscesses are localized collections of pus, usually underneath the right or left hemi- diaphragm.There  is a accumulation of infected fluid between the diaphragm, the liver and the spleen Abstract: "We describe an unusual case of subphrenic abscess complicating a central venous catheter infection caused by Pseudomonas aeruginosa in a 59-year-old woman undergoing hemodialysis. The diagnosis was made through computed tomography, and Pseudomonas aeruginosa was isolated from the purulent drainage of the subphrenic abscess, the catheter tip and exit site, and the blood culture samples. A transesophageal echocardiography showed a large tubular thrombus in superior vena cava, extending to the right atrium, but no evidence of endocarditis or other metastatic infectious foci. Catheter removal, percutaneous abscess drainage, anticoagulation, and antibiotics resulted in a favourable outcome." Introduction: "Infection is a common complicati...

  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...

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...