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.