Vessel Health and Preservation : : the Right Approach for Vascular Access.

• Author: Moureau, Nancy L.
• Place / Publishing House: Cham : : Springer International Publishing AG,, 2019.; ©2019.
• Year of Publication: 2019
• Edition: 1st ed.
• Language: English
• Physical Description: 1 online resource (303 pages)

Table of Contents

Intro -- Foreword -- Acknowledgments -- Contents -- About the Editor -- About the Authors -- Part I: Vessel Health and Preservation (VHP) -- 1: The VHP Model -- 1.1 Introduction to Vessel Health and Preservation -- 1.2 Four Quadrants of Care -- 1.2.1 Quadrant 1: Right Assessment, Vein, and Device Selection -- 1.2.2 Quadrant 2: Right Insertion and Training -- 1.2.3 Quadrant 3: Right Management -- 1.2.4 Quadrant 4: Right Evaluation -- References -- 2: Right Assessment and Vein Selection -- 2.1 Introduction -- 2.2 Patient and Vein Assessment -- 2.3 Vessel Assessment -- 2.4 Ultrasound Assessment of the Patient -- 2.5 Rapid Vein Assessment RAPEVA and RACEVA Protocols (Pittiruti and Scoppettuolo 2017) -- 2.5.1 RAPEVA Position 1 -- 2.5.2 RAPEVA Position 2 -- 2.5.3 RAPEVA Position 3 -- 2.5.4 RAPEVA Position 4 -- 2.5.5 RAPEVA Position 5 -- 2.5.6 RAPEVA Position 6 -- 2.5.7 RAPEVA Position 7 -- 2.6 RACEVA Rapid Central Vein Assessment -- 2.6.1 RACEVA Position 1 -- 2.6.2 RACEVA Position 3 -- 2.6.3 RACEVA Position 4 -- 2.6.4 RACEVA Position 5 -- 2.6.5 RACEVA Position 6 -- 2.6.6 RACEVA Position 7 -- 2.6.7 RACEVA Position 8 -- References -- 3: Device Selection -- 3.1 Types of Vascular Access Devices -- 3.2 Short Peripheral Intravenous Cannula (PIVC) -- 3.3 Extended Dwell Peripheral (EDP) Cannula -- 3.4 Midline Catheter -- 3.5 Central Venous Access Device -- 3.5.1 Peripherally Inserted Central Catheter (PICC) -- 3.5.2 Non-tunnelled Acute Care Catheter -- 3.5.3 Tunnelled Long-Term Catheter -- 3.5.4 Subcutaneous Implanted Intravenous Port -- 3.6 Other VAD Selection Factors -- 3.6.1 Quality of Infusate -- 3.6.2 Length of Therapy -- 3.6.3 Patient Assessment for Device Selection -- 3.6.4 Evaluation of Patient Risk Factors -- 3.6.5 Stage 1 Assessment: Skin Condition (Fig. 3.5).

3.6.6 Stage 2 Assessment: Vein Conditions and Special Requirements -- 3.6.7 Limited Peripheral Access -- 3.6.8 High-Volume Fluid Needs -- 3.6.9 Circulatory Status -- 3.6.10 Previous Complications -- 3.6.11 Critical Factors -- 3.6.12 Other Conditions -- 3.6.13 Paediatric Patients -- 3.6.14 Stage 3 Assessment: Interventional Radiology Placements -- 3.6.15 Peripheral Versus Central Venous Access Devices (CVAD vs PIVC) -- 3.6.16 Home vs Inpatient Treatment -- 3.7 Device-Specific Features -- 3.7.1 Indications for Multi-lumen Catheters -- 3.7.2 Catheter Size -- 3.7.3 Dialysis, Apheresis and Other Pulmonary Arterial Catheters -- 3.8 Conclusion -- References -- Part II: Right Education -- 4: Training and Education -- 4.1 Introduction -- 4.2 The Need for Adequate Education -- 4.3 The Right Education: Insertion Training -- 4.4 Right Education for PIVC Success -- 4.5 Approaches to Training -- 4.5.1 Anatomy and Physiology -- 4.5.2 Use of Ultrasound -- 4.5.3 Catheter Tip Position -- 4.5.4 Infection Prevention -- 4.5.5 Insertion Technique -- 4.6 Insertion and Post Insertion Bundles -- References -- 5: Specialized Vascular Access Teams -- 5.1 Introduction -- 5.2 Vascular Access Teams Defined -- 5.3 Vascular Access Specialist Defined -- 5.4 Evidence Supporting Vascular Access Specialist Team -- 5.5 What the Guidelines Recommend -- 5.6 Benefits of Vascular Access Specialist Team -- 5.7 Summary -- References -- Part III: Right Insertion -- 6: Insertion -- 6.1 Introduction to Insertion -- 6.2 Appropriateness in Device Selection -- 6.3 Optimal Peripheral Cannula Insertion -- 6.4 Selection of an Insertion Site for PIVC Cannulation -- 6.4.1 Vein Characteristics -- 6.4.2 Skin Considerations -- 6.5 Safe Practices for Insertion -- 6.6 Recommendations for PIVC Insertion -- 6.7 Patient Assessment and Insertion.

6.7.1 Needle Design and Quality -- 6.8 Additional Products -- 6.9 CVAD Insertion Preparation -- 6.9.1 Insertion Environment -- 6.9.2 Local Anesthetic -- 6.10 Seldinger Technique -- 6.10.1 Guidewire Advancement Difficulties -- 6.10.2 Guidewire Check -- 6.11 Number of Access Attempts -- 6.12 Conclusion -- References -- 7: Tip Position -- 7.1 Introduction -- 7.2 Vascular Access Device Terminal Tip Positioning -- 7.3 Anatomy -- 7.4 ECG Tech Development -- 7.5 Steps for Placing ECG-Guided PICC with Guidewire Technique (Moureau et al. 2010) -- 7.6 Steps for Placing ECG-Guided PICC with Saline-Filled Lumen (Moureau et al. 2010) -- 7.7 Tip Movement -- 7.8 Thrombosis -- 7.9 Conclusion -- References -- 8: Avoiding Complications During Insertion -- 8.1 Introduction -- 8.2 Arterial Access -- 8.3 Vein Wall Injury -- 8.4 Nerve Injury -- 8.5 Air Embolism -- 8.6 Different Veins and Associated Risks -- 8.7 Axillary (Subclavian) Versus Jugular -- 8.8 Internal Jugular -- 8.9 Stenosis -- 8.10 Femoral Approach -- 8.11 Infection and Femoral Site -- 8.12 Conclusion -- References -- 9: Right Securement, Dressing, and Management -- 9.1 Introduction -- 9.2 Purpose of Securement -- 9.3 Types of Securement -- 9.4 Gauze and Tape Securement -- 9.5 Transparent Dressings -- 9.6 Adhesive Securement Platforms -- 9.7 Tissue Adhesive Securement -- 9.8 Subcutaneous Securement -- 9.9 Sutures -- 9.10 Add-On Securement Devices -- 9.11 Impact of Inadequate Securement -- 9.12 Conclusion -- References -- Part IV: Right Infection Prevention -- 10: Insertion Related Infection Prevention with Vascular Access Devices -- 10.1 Introduction -- 10.2 Hand Hygiene -- 10.3 Maximal Barrier Precautions -- 10.3.1 Sterile Gown -- 10.3.2 Gloves -- 10.3.3 How to Don Sterile Gloves -- 10.3.4 Sterile Drapes -- 10.4 Patient Skin Preparation.

10.5 Appropriate Skin Decontamination -- 10.6 Ultrasound -- 10.7 Site Selection -- 10.8 Daily Review of Line Necessity -- 10.9 Use of Insertion Checklists and Observers -- References -- 11: Right Asepsis with ANTT® for Infection Prevention -- 11.1 Which Aseptic Technique Is the 'Right' Aseptic Technique? -- 11.2 Aseptic Non Touch Technique (ANTT®) -- 11.3 The ANTT® Clinical Practice Framework Explained -- 11.4 ANTT®: Key-Part and Key-Site Protection -- 11.5 Aseptic Fields -- 11.6 Right Aseptic Technique: ANTT® Applied to IV Therapy -- 11.6.1 Right Aseptic Technique: ANTT® Applied to the Insertion of Central Venous Access Devices (CVAD) -- 11.6.1.1 Overview -- 11.6.1.2 ANTT® Risk Assessment for CVAD Insertion -- 11.6.1.3 Basic Precautions for CVAD Insertion -- 11.6.1.4 Decontamination and Disinfection for CVAD Insertion -- 11.6.1.5 Aseptic Fields in CVAD Insertion -- 11.6.1.6 Non-touch Technique for CVAD Insertion -- 11.6.2 Right Aseptic Technique: ANTT® Applied to the Insertion of Peripheral Venous Catheter -- 11.6.2.1 Overview -- 11.6.2.2 ANTT® Risk Assessment for PVC Insertion -- 11.6.2.3 Basic Precautions for PVC Insertion -- 11.6.2.4 Decontamination and Protection for PVC Insertion -- 11.6.2.5 Aseptic Fields in PVC Insertion -- 11.6.2.6 Non-touch Technique for PVC Insertion -- 11.6.3 Right Aseptic Technique: ANTT® Applied to Intravenous Maintenance -- 11.6.3.1 Overview -- 11.6.3.2 ANTT® Risk Assessment for IV Maintenance -- 11.6.3.3 Basic Precautions for IV Maintenance -- 11.6.3.4 Decontamination and Protection for IV Maintenance -- 11.6.4 Procedure Tray Disinfection -- 11.6.5 IV Hub Disinfection -- 11.6.6 Passive IV Hub Disinfection -- 11.6.6.1 Aseptic Fields in IV Maintenance -- 11.6.6.2 Non-touch Technique for IV Maintenance -- 11.6.7 Right Aseptic Technique: ANTT® Applied to Central Line Dressing Change.

11.6.7.1 Overview -- 11.6.7.2 CVAD Dressings -- 11.6.7.3 ANTT® Risk Assessment for CVAD Dressing Change -- 11.6.7.4 Basic Precautions for CVAD Dressing Change -- 11.6.7.5 Aseptic Fields in CVAD Dressing Change -- 11.6.7.6 Non-touch Technique for CVAD Dressing Change -- 11.6.7.7 Decontamination for CVAD Dressing Change -- 11.7 ANTT® Clinical Governance: Competency, Compliance and Surveillance -- 11.7.1 Competency -- 11.7.2 Implementation -- 11.7.3 Compliance -- 11.7.3.1 Surveillance of Practice -- 11.7.3.2 Surveillance of Outcomes -- 11.7.4 Developing a Meaningful Evidence Base for Aseptic Technique -- References -- 12: CLABSI: Definition and Diagnosis -- 12.1 Surveillance Definition -- 12.1.1 CDC CLABSI Protocol -- 12.2 Understanding the Goals and Limitations of Surveillance Definitions -- 12.3 Using CDC Protocol Beyond Central Lines -- 12.4 Brief Primer on How to Interpret Surveillance Data -- 12.4.1 CLABSI Rate -- 12.4.2 Central Line Device Utilization Ratio -- 12.4.3 Standardized Infection Ratio -- 12.5 Understanding Variations and Limitations in Technique for Diagnosing CRBSI -- 12.6 Summary -- References -- Part V: Right Pediatric Vessel Health and Preservation -- 13: Developmental Stages and Clinical Conditions for Vascular Access in Pediatrics -- 13.1 Introduction -- 13.2 Vascular Access-Related Anatomical, Physiological, and Developmental Variations by Age Group -- 13.2.1 Neonatal (&lt -- 28 Days) -- 13.2.2 Infants (28 Days-1 Year) -- 13.2.3 Toddler (1-3 Years) -- 13.2.4 Preschool to School-Age Children (3-12 Years) -- 13.2.5 Adolescents (13-18 Years) -- 13.3 Common Pediatric Conditions Which Are Vascular Access Dependent -- 13.3.1 Short Bowel (Gut) Syndrome -- 13.3.2 Cystic Fibrosis -- 13.3.3 Hematological Disorders -- 13.3.4 Nonmalignant Hematological Disorders -- 13.3.5 Malignant Hematological Disorders.

13.3.6 Oncological Conditions.