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A Nurse-Led Ultrasound-Enhanced Vascular Access Preservation Program

Reeves, Turena, ADN, RN, OCN, VA-BC; Morrison, Dolores, MSN, RN, ACNS-BC; Altmiller, Gerry, EdD, APRN, ACNS-BC

AJN The American Journal of Nursing: December 2017 - Volume 117 - Issue 12 - p 56–64
doi: 10.1097/01.NAJ.0000527490.24610.51
Cultivating Quality
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Insertion of peripheral iv catheters is a common practice in medical–surgical care settings. The frequency with which attempts are made to insert catheters causes rapid peripheral vessel depletion (a reduction in the number of usable veins), leading to the overuse of unnecessary central line catheters. Reducing central line–associated bloodstream infections is a national health care priority. In this quality improvement report, the authors describe the implementation of a nurse-led vascular access preservation program using ultrasound technology as a method to reduce the use of nonessential peripherally inserted central catheters.

How one institution reduced its catheter failure rate and use of nonessential peripherally inserted central catheters by initiating a practice change involving an ultrasound-guided insertion technique.

Turena Reeves is a quality management coordinator and Dolores Morrison is a clinical nurse specialist at Einstein Medical Center Philadelphia. Gerry Altmiller is an associate professor of nursing at the College of New Jersey, Ewing, and a consultant for Einstein Medical Center Philadelphia. Contact author: Dolores Morrison, morrisod@einstein.edu. Reeves and Morrison received an in-house grant from the Albert Einstein Society to implement this quality improvement project. The authors have disclosed no potential conflicts of interest, financial or otherwise.

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