development of an intravenous access team...
TRANSCRIPT
KerryTaliaferroCNC
IntravenousAccessTeam
CanberraHospitalACT
AVASASM2017
DEVELOPMENT OF AN INTRAVENOUS ACCESS TEAM CREDENTIALING PACKAGE
Financial Disclosures
1.DisclosureofRelevantFinancialRelationships
Ihavenofinancialrelationshipstodisclose
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Canberra Hospital & Health Services
Acutecareteachinghospital
600inpatientbeds
ServicesACT&SouthernNSW
Providesspecialistandacutecaretomorethan500,000people
IVATestablished2014
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International Programs
PICCACADEMYNETWORK(PAN)• TraintheTrainer• 40• Expense• RecognitioninAustralia
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WoCOVA evidence based consensus
• StandardminimalrequirementsfortrainingonCVAD’s
• 16recommendationsaskeytoensuringsafeandcompetentpractice
• Standardiseeducation
• Simulationpractice
• Supervisedinsertions
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The Basics
• A&P• Ultrasound• CVADknowledge• Infectioncontrol&SurgicalANTT• Deviceselection• Insertionmethods• Troubleshooting• CareandMaintenance• Proficiencyandcredentialing
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Adult learning methods
• Experientiallearning• Integrationofknowledge,activityandreflection
• Experientialeducation• Takeintoaccountlearnersknowledgebase/experience
• Situatedlearning• Active/guidedparticipationthroughapprenticeship• Communityofpractice• Student– Mentor
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Offer Variety
• Facetoface
• Elearning
• External
• Internal
• Simulation
• Handsonsupervised
• Formalobjectivecredentialing
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The Learner
• Gainknowledge,skills,competency
• Establishedrequiredstandards
• Achieveidentifiedoutcomes
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CredentialingCriteriaforPICCInsertionsforIVATmembers
PreRequisites
CompetencyAchievedin
SuccessfulapplicationtoIVATRN2role
Venepuncture andbloodcollection
Intravenouscannulation
TrainingduringIVATRN2roletoachievePICCinsertioncompetency
AttendonedayUltrasoundguidedPICCinsertionworkshop
Completethesee-learningprograms
Consent
Aseptictechnique
CVADCareandmaintenance
PatientidentificationandProcedurematching
Scrubbinggowningandgloving
OneononelectureonCVAD’sandUltrasoundguidedaccesswithIVATCNCandStaffspecialistICU
SupervisedPICCinsertionswithIVATCNC– until
PassIVATCVADinsertionandcareexam
FormalClinicalCompetencyofprocessfromreferraltocompletedinsertionandfollowup
OrientationtotheIVATRN2role
VascularAccessDeviceSelection,InsertionandManagementOnlineCourse(CourseCost:$50.00- optional)
UltrasoundforPeripheralAccessTrainingCourse
Sherlock3CG*TipConfirmationSystem(TCS)TrainingCourseandcompetency
Completeelearning programsathttps://www.bardaccess.com/clinical_training/login.php
MaintainInsertionSkillsReassessmentEvery3years
DIVISIONOFMEDICINEExecutiveDirectorofMedicine
DirectorofNursing
AmbulatoryServicesAssistantDirectorofNursing
INTRAVENOUSACCESSTEAM
IVATCNC
NHSQSTANDARD3.9.1:INVASIVEDEVICES STANDARD3COMMITTEE
Scrubbinggowningandgloving/SurgicalANTT/ECGTCSPracticalassessment Obtain
Ultrasoundguidedaccesstrainingandcompetency
TraininginECGTCS
IVATRN2
Training for IVAT RN 2 role
• OrientationtoIVATRN2role• AttendexternalonedayUltrasoundguidedPICCinsertionworkshop
• OneononelecturesonCVAD’sandUltrasoundwithCNCandStaffspecialistICU
• S,G&G/SurgicalAseptictechniquetraining
• SupervisedPICCinsertionswithCNC
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Assessments
• S,G&G/Aseptictechnique>Practicalassessment• FormalClinicalCompetencyofprocessfromreferraltocompletedinsertionandfollowup• PassIVATCVADinsertionandcareexam
• MaintainInsertionSkills
• Reassessmentannually
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Competency based assessment
Fourdomains• ProfessionalPractice
• CriticalThinkingandAnalysis
• ProvisionandCoordinationofCare
• CollaborativeandTherapeuticPractice
ArandaS,YatesP.Competencyassessmenttoolformanagementofcentralvenousaccessdevices(CVADs).Canberra:TheNationalCancerNursingEducationProject(EdCaN),CancerAustralia;2009.
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PERFORMANCE LEVEL
COMPETENTEstablishedcompetenceasaspecialistwithintheirclinicalfieldofpracticeCOMPETENTBeginningcompetenceasaspecialistwithintheirclinicalfieldofpracticeNOTYETCOMPETENT
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Written exam topics
• Anatomy&Physiology• Patientassessment&deviceselection• Insertion• Documentation• Complications• Management• Scenarios
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Ultrasound Skills
33
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
HoldingtheProbeSteady
Identifyingvessels/nerves/structures
AccessingveinsforPICCinsertion
AccessingveinsforPIVC
(cannula) insertion
Identifyingtheneedletip
RankedEasiest(1)toHardest(5)
AverageRank
LowestRanked
HighestRanked
Did you undertake independent research for the exam?
Yes=3No=1• Hospitallibrary• Generalanatomyfromtestbooks• Hospitalpolicy• Intravenousaccessjournals• BARDonlinearticles
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Knowledge level
37
0
10
20
30
40
50
60
70
80
90
100
Lowestranking Highestranking Averageranking
HowwouldyourateyourknowledgeofCVAD'sonascaleof1to100(100=expert)
BeforeTraining Aftertraining
Validation
• NHSQSAccreditation2105• Standard3HAICommittee• SDU- Capabiliti• EducationActivityReport• RegisteredVET
• ValidationbyexternalPICCCNC
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