assessment and device selection for vascular access
TRANSCRIPT
ALL CARE
DELIVERED NEEDS
TO BE EVIDENCE
BASED.
• Research
1 STEP
• Publication
2 STEP• Change in
practice
3 STEP
• SAFEST/BEST CARE POSSIBLE
GOAL
SO MANY INFORMATIONS AND SO LITTLE TIME!!
RCN
INS
AVA
WEB SEARCH :ATHENS,
PRACTICE
EDUCATION
ORGANIZATION/ STRUCTURE
Assessment and Device Selection
Client Education
Documentation
All clients requiring vascular access,
regardless of the duration of therapy.
RCN recommends the use of structured
approach and the development of a
vascular access care plan prior to the
initiation of therapy .
Prescribed therapy
Duration of therapy
Physical assessment
Client health history
Supporting system/resources
Device availability
Client preferences
Prescribed therapy
PH and Osmolarity
Frequency of blood sampling
Type of therapy
ACID
NEUTRAL
ALCALINE
The concentration of particles dissolved
in each solution .
In human plasma, the concentration of
dissolved paricles is about 290x10(3)
A PH outside the range of 5-9 and/or
osmolarity greater than 500 Mosm/l
should be administered with a suitable
central venous device
Maki(1991) :27-70 % of patient receiving
peripheral infusion therapy develop
phlebitis
The incidence of phlebitis rises
progressively with increasing length of
cannulation.
30%
39-49%
70-88%DAY 2
DAY 3
DAY 4
Mercer Ward ( oncology/haematology
and respiratory)
30 beds
December 2008 :12 patients with length
of stays between 7-15 days
11 patients on some forms of IV therapy
Vascular assessment and device
selection: RNAO , 2007
RCN” Guidelines for Intravenous
therapy”,2005
L.Doherty “ care and management of
central line catheters”,2006