Girgenti, C. and Donnellan, E. (2015) A Vascular Access Team’s Journey to Central Venous Catheter and Arterial Line Placement. The Journal of the Association of Vascular Access. 20(2), p.69–74.
Background: The frequency with which vascular access specialists (VASs) are placing peripherally inserted central catheters (PICCS) has allowed for the improvement and expansion of the skill set by using advanced insertion techniques such as the modified Seldinger technique and ultrasound for real-time imaging. The use of real-time imaging has decreased complications such as arterial puncture and has improved success rates. Due to this positive influence on patient outcomes, many VASs are moving to the placement of central venous catheters (CVC).
Method: We describe the service improvement process of expanding a vascular access team (VAT) practice to include the placement of CVCs and arterial lines in a large community hospital in Illinois. We also outline the history of vascular access and the journey of a VAT.
Results: By following a methodic approach toward implementation of practice expansion, our VAT has gone from solely placing PICCS to the placement of CVCs in the internal jugular, axillary/subclavian, and femoral veins and to the placement of arterial lines.
Conclusions: VASs have the capacity to positively influence patient safety and outcomes even further by placing CVCs, rather than simply staying with the current scope of practice by placing intravenous lines, midlines, and PICCs. Patient outcomes will improve as VASs move to the placement of CVCs, and the costs associated with potential complications will improve also. Moving to the placement of CVCs is vital to the specialty of vascular access and will continue the breadth and depth of service provided by VASs.
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