Gaining access to a vein, venous access, is a critical skill necessary for basic patient care in both the hospital and ambulatory patient settings. There are several different forms of Venous Access Devices and today we will briefly examine each of the different devices and their uses or contraindications.
Peripheral IV – These devices are ideal for short-term access (no more than 72 hours in the same site). The majority of short term situational needs can be meet with a conventional PIV line. Veins can be accessed on the hand, arm, or even foot.
Peripherally Inserted Central Catheters – PICC’s are commonly inserted in either the basilic, brachial, or cephalic veins and many facilities utilize skilled nursing teams to insert them. These insertions should only be used when absolutely needed – common uses include parenteral delivery of nutrition, antibiotics, analgesics, chemotherapy, or repeated blood transfusions.
Centrally Inserted Catheters – There are three main types of centrally inserted catheters:
Non-Tunneled Catheters – used for short term time frames in an emergency department, operating room, or intensive care unit.
Skin-Tunneled Catheters – Traditionally used for longer residence, these are commonly used in patients requiring frequent and long-term venous access, particularly for infusion of blood products.
Implantable ports – Consists of a catheter attached to a reservoir that is implanted into a surgically created pocket on the chest wall. These devices are expensive, difficult to insert, and time-consuming to remove.
It is important to note that there are no “infection or complication proof” venous access devices. Each process runs the risk of complications and it is absolutely crucial that nursing teams are familiar with the different forms of complications and that they are able to educate the patient and family as well. Patient education can help nursing teams identify complications earlier as patients will be able to notice developing issues.
IV insertions and infusions are among the most common hospital procedures performed in health care facilities around the world. Despite their regularity of use, it is essential for health care providers to consistently seek out the most current evidence based IV therapy information in order to provide consistently high levels of patient care.
Although there are a wide range of online IV therapy continuing education providers, nothing can replace practical at the bedside training by an infusion nurse who is familiar with the evidence based methods for Intravenous insertions. Regular training consisting of evidence based material reviews and practical hands-on learning are essential to maintaining an evidence based nursing culture.
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