Your browser (Internet Explorer 7 or lower) is out of date. It has known security flaws and may not display all features of this and other websites. Learn how to update your browser.

If you are using IE 9 already, make sure you turn off "Compatibility View".

X

MEMBERS ONLY

Some of these articles are reserved for CVAA Members only. To access the complete article please log in here.

This is a members only article. You must login here to access the complete article.


Journal Volume: 8
Journal Number: 2
Article Author: Tomoko Uemoto, RN, CON(C)

Intravenous (IV) tubing set up for chemotherapy/biotherapy can be as complicated as a subway map in a big city due to increased complexity and volume of recent combination protocols. Safety concerns for the handling of biohazard drugs have made the set up for IV tubing more complex.

[Read the rest of this article...]


This is a members only article. You must login here to access the complete article.


Journal Volume: 8
Journal Number:  1
Article Author: Kristie Naayer, RN, BScN, CVAA(c)

Patient assessment is an important aspect of vascular access and of a vascular access team. A team composed of nurses that insert peripherally inserted central catheters (PICC) needs to have a consistent form of assessment of patients prior to inserting PICCs.  These nurses also need to have a consistent form of communication to one another regarding these assessments.  The assessment tool provided gives a detailed view of the patient and areas that the nurse needs to be aware of and alert to.  This consistent assessment and communication allow the PICC nurses at Abbotsford Regional Hospital to provide quality and efficient vascular care to patients.


[Read the rest of this article...]


This is a members only article. You must login here to access the complete article.


Journal Volume: 8
Journal Number: 1
Article Author: Daphne Broadhurst, BScN, RN, CVAA(c) and Rosemary Zvonar BScPhm, ACPR, FCSHP

Abstract:
Aminoglycoside and vancomycin administration present toxicity-related risks to the patient and medical liability to health care organizations. This article presents a clinical tool designed to promote optimal nursing assessment and laboratory monitoring of home care patients to aid the prevention, early recognition, and management of toxicities related to aminoglycosides and vancomycin.


[Read the rest of this article...]


This is a members only article. You must login here to access the complete article.


Journal Volume: 7
Journal Number:  3
Article Author: Gillian Strudwick, RN, MN, CVAA(c), Michelle DaGloria, RN, BScN, Karen Charron, RN, MHSM, Renee Logan, RN, CVAA(c), Allison Fournier, RN, BNSc, Cathy Murray, RN, BScN, MScN(Cand), Patricia Rodgers, RN, Ed(Adult), CNCC

Abstract:
In this article, the authors review an article by Rickard et al., published in The Lancet, that discusses a large randomized controlled study of the safety of peripheral intravenous catheters.

[Read the rest of this article...]


This is a members only article. You must login here to access the complete article.


Journal Volume: 7
Journal Number: 3
Article Author: Wava Truscott, PhD, MBA

Abstract: This is part 2 of a two-part article. Part 1, published in Issue 7-2 of Vascular Access, discussed the risk, outrage, and honours associated with central line development and provided descriptions of the complications associated with this essential medical device. 

[Read the rest of this article...]


This is a members only article. You must login here to access the complete article.


Journal Volume: 7
Journal Number: 3
Article Author: Brent Burbridge, MD, FRCPC, Gilbert Matte, BPharm, PhD, Haven Roy, MA

Abstract: Intravascular contrast agents are administered during computed tomography (CT) examinations to alter the density of blood vessels and soft tissues. This allows for the transient modification of the appearances of different structures, which aids in detecting abnormalities of anatomy. We propose to discuss the relevant chemistry of these agents, how they are commonly administered during different CT examinations of the body, and the impact that different modes of administration of the contrast agents (i.e., peripheral vein intravenous, peripherally inserted central vein catheter, and central venous catheters) may have on the administration of contrast intravenously.


[Read the rest of this article...]


Journal Volume: 7
Journal Number: 2
Article Author: Wava Truscott, PhD, MBA

Abstract:  Central lines are essential for the infusion of potent vasoactive drugs, highly osmotic or hypertonic solutions, total parenteral nutrition, incompatible medications, and cytotoxic drugs as well as for hemodialysis, hemofiltration, and hemodynamic monitoring. In the United States alone, between 5 and 6 million central lines are placed annually. The frequency of central line–associated complications is estimated to be between 5% and 19% depending on definitions and numerous vulnerability factors. The complications can be so devastating that efforts to prevent their occurrence should be routine elements of any related quality improvement program. There are several preventive measures that can be undertaken before, during, and after catheter insertion to reduce patient risk. Some are almost universally practised, but others are rarely formally integrated into procedure requirements. Many of these measures are discussed in this two-part article.

[Read the rest of this article...]


This is a members only article. You must login here to access the complete article.


Journal Volume: 7
Journal Number: 2
Article Author: Sarah Champ, RN, BScN, CON(C)

Abstract:  Central venous access devices (CVADs) are integral to the treatment of oncology patients. Since oncology patients receive many high-risk medications and undergo treatments over a long period of time, CVADs have become an important part of their care to preserve their veins. However, CVADs come with a cost; they have a high risk of complications such as central line–associated bloodstream infections (CLABSIs). As the majority of patients are seen in ambulatory care settings, many patients go home with these devices, and subsequently provide the required care and maintenance. There is a need for appropriate patient education on the care of CVADs to prevent CLABSIs. This article reviews the process used in an ambulatory care centre to standardize patient education for patients who are required to receive a CVAD. The educational tools encompass a constructivism basis, encouraging the nurse to assess the patient and to build upon previous knowledge. Principles of adult education are utilized, such as including the patient as an active participant, using plain language, and incorporating a variety of learning styles.

[Read the rest of this article...]


This is a members only article. You must login here to access the complete article.


Journal Volume: 7
Journal Number: 2
Article Author: Brent Burbridge, MD, FRCPC

Abstract:  The provision of long-term intravenous therapy can be significantly enhanced through the availability of reliable, functional venous access. Vein ports are a commonly utilized solution for patients requiring long-term intermittent intravenous therapies. Chest and arm placements of these types of venous access systems are two distinct options. This essay discusses and illustrates the processes associated with the implantation of a miniaturized arm port that is commonly used for intravenous therapy in the author’s health district. This is a venous access device that has been implanted, with considerable frequency, in the author’s hospital since 1995.

[Read the rest of this article...]


This is a members only article. You must login here to access the complete article.


Journal Volume: 7
Journal Number: 1
Article Author: Daphne Broadhurst, RN, BScN, CVAA(c)

Abstract:  Air is an essential life-sustaining element – but too much of a good thing can be harmful. While the incidence of air embolism may be low and most cases are likely subclinical, this vascular access device–related condition has the potential for severe neurological, respiratory, and cardiovascular morbidity and mortality. The clinical relevance of a small air embolism is uncertain, as is the amount of air required to cause harm. As this potentially catastrophic complication of infusion therapy is completely avoidable, one case is one too many. This article presents published case reports that illustrate the potential gravity of this complication.

[Read the rest of this article...]


This is a members only article. You must login here to access the complete article.


Journal Volume: 7
Journal Number: 1
Article Author: Gillian Strudwick, RN, MN, CVAA(c), Michelle DaGloria, RN, BScN, Karen Charron, RN, MHSM, Renee Logan, RN, CVAA(c), Allison Fournier, RN, BNSc, Cathy Murray, RN, BScN, MScN(Cand), Patricia Rodgers, RN, BEd (Adult), CNCC(c)

Abstract

Purpose: In Canada, nurses provide the majority of care for vascular access devices. To date, no known Canadian assessment has been completed to assess the kinds of practices that are utilized by nurses to prevent catheter occlusions. Furthermore, there is no “bundle” of practice strategies, like there are for catheter-related bloodstream infections, for the prevention of catheter occlusions that can be used as a standard for care.

The purpose of this work is to understand catheter occlusion prevention practices currently being utilized in Canada. 

Methods: A survey of 37 questions was developed based on four themes of catheter occlusion prevention strategies identified in literature. In addition, questions related to demographics were also asked of the participants. All CVAA members received the opportunity to fill out the survey via an emailed link to the online survey, and twice the executive director encouraged members to complete the survey.

Results: The survey provided insight and a basis for future Canadian practices surrounding the prevention of catheter occlusions. Some of the more interesting findings were related to the average years of experience nurses typically have who filled out the survey, recurring education practices, perceptions of technologies that may help reduce catheter occlusions, and monitoring strategies that are currently present.

Conclusion: It is hoped that information collected from this work will be a foundation of knowledge to help the Canadian Vascular Access Association to provide tools and resources and to inform meaningful future research on this important topic.


[Read the rest of this article...]


This is a members only article. You must login here to access the complete article.


Journal Volume: 6
Journal Number: 2
Article Author: Andrea Hunter, BS, RN, and Mark R. Hunter RN, CRNI, VA-BC

Abstract:  The North American Nursing Diagnosis Association International (NANDA-I) is the leader in the development of nursing diagnoses that help to improve overall patient safety and ultimately save lives. Nursing diagnoses provide an explanation for actions, identify expected outcomes, and are founded on evidence-based information, including literature, nurse experiences, and knowledge. The incidence of hospital-acquired infections such as central line–associated blood stream infections continues to plague our patients; therefore, it has become apparent that following a single plan of care that includes a nursing diagnosis of risk for infection has the potential to decrease this risk. This article discusses NANDA-I, the importance of using nursing diagnoses to help treat existing conditions and prevent new ones from occurring, and how the diagnosis of risk for infection has been revised to include new risks that are evidence based. It also details the many benefits of using this communication tool to provide the best possible outcome for each patient. 

[Read the rest of this article...]


This is a members only article. You must login here to access the complete article.


Journal Volume: 6
Journal Number: 2
Article Author: Sheryl McDiarmid, RN, BScN, MEd, MBA, ACNP, AOCN

Abstract:  In a knowledge economy, comprehensive and accurate data are arguably the most important resource needed for sound decision making and for process improvement initiatives. However, the collection and use of data in a systematic, purpose-driven manner by health care professionals is sporadic. The Corporate Vascular Access Device (CVAD) Program, led by an advanced practice nurse (APN), was established at The Ottawa Hospital (TOH) in 2008. Early on, the APN designed the Microsoft Access Database V-ASK to capture data on patient demographics, diagnosis, reason for central line insertion, type of line, date and reason for removal, and complications associated with the device. To date, extensive data have been collected on over 16,000 central lines, including peripherally inserted central catheters, subcutaneous ports, and tunnelled catheters. Data have also been captured on over 6,000 problems and subsequent interventions related to the catheters inserted.

[Read the rest of this article...]


This is a members only article. You must login here to access the complete article.


Journal Volume: 6
Journal Number: 2
Article Author: Daphne Broadhurst, RN, BScN, CVAA(c)

Abstract:  No abstract available.

[Read the rest of this article...]