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...

EBOLA The Ebola virus has been around for quite some time and in fact first appeared in 1976 in the Democratic Republic of Congo. 1 However, with the invention of social media our population has 24 hour news coverage and this news can be brought to us immediately from around the world. We have recently seen an uptick in the discussion of the Ebola Virus due to the recent outbreak in Western Africa. “The U.S. Centers for Disease Control and Prevention said that from 550,000 people to as many as 1.4 million people when under reporting of cases is taken into account could be infected by mid-January in Liberia and Sierra Leone, in a worst-case scenario generated by a computer modeling tool the agency constructed. Around 21,000 cases would occur by Sept. 30.” 2 So with this information at your fingertips; are you ready for the increase in Ebola cases here in the U.S.? Is your hospital and medical staff ready to treat these types of patients? “The current outbreak in West Africa, ...

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." ...

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...

Infusion Therapy is a growing industry and we have more and more patients going home with implanted ports, temporary dialysis catheters, and other types of Central Venous Catheters (CVC).  We get many questions regarding the scope of LVN's/LPN's and what they can and cannot do in regards to infusion therapy. For the sake of this article we will use the term Licensed Vocational Nurse (LVN) as this is what they are referred to here in California.  However, most states still refer to an LVN as and LPN or Licensed Practical Nurse.  That is another discussion in its entirety. California is one of the only states that we know of at this time that requires LVN's to gain an IV Certification in order to perform IV Therapy .  Pedagogy has a great link that one may use as a resource to determine what an LVN can and cannot do in regards to infusion therapy . Here is California it is illegal for a Medical Assistant (MA) to start an IV or even access a central ...

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...