Course Access
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Morning Brains Trust.
Can you advise on any published document/standard/ policy that supports appropriate number of PIVCs before alternative route of access is considered.
Thank you so much in advance.
Holly
Holly Dodd
Infection Prevention and control Clinical Nurse Consultant
Sydney Adventist Hospital | 185 Fox Valley Road, Wahroonga, NSW 2076
Monday- Thursdayp: +61 2 9847 9433 | f: +61 2 9473 8053 | m: +61 408468470 | e: Holly.Dodd@sah.org.au
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Hi Holly,
To my knowledge there isn’t. I have seen 20 attempts on non time
critical access (not at the hospital I work in). I guess you have to be
dictated by your conscience and the guide to first do no harm. Where I
work you are allowed 2 attempts then you have to get someone with
greater experience unless you are a med student and then you only get 1.
If it is time critical you generally have a minute or 2 to get access
and then must go IO. I know this isn’t a lot of help. I think the
practitioner has to be realistic when assessing and realise when they
cannot feel what they need to feel. Use the vein finder or ultrasound
but don’t stick 20 holes in someone.Angela Carvosso
Registered Nurse
Infection Control Portfolio
Warwick Hospital—— Original Message ——
consideredMorning Brains Trust.
Can you advise on any published document/standard/ policy that supports
appropriate number of PIVCs before alternative route of access is
considered.Thank you so much in advance.
Holly
Holly Dodd
Infection Prevention and control Clinical Nurse Consultant
Sydney Adventist Hospital | 185 Fox Valley Road, Wahroonga, NSW 2076
Monday- Thursdayp: +61 2 9847 9433 | f: +61 2 9473 8053 | m: +61 408468470 | e:
Holly.Dodd@sah.org.au
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Hi Holly
The Queensland Health guidelines make this statement (page 4):
https://www.health.qld.gov.au/__data/assets/pdf_file/0025/444490/icare-pivc-guideline.pdf
It is recommended that clinicians make no more than two attempts at cannulation before seeking assistance from a more experienced clinician, unless it is a medical emergency or no other clinicians are available.
There are a couple of references attached to that statement, so worth checking them.
Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]Morning Brains Trust.
Can you advise on any published document/standard/ policy that supports appropriate number of PIVCs before alternative route of access is considered.
Thank you so much in advance.
Holly
Holly Dodd
Infection Prevention and control Clinical Nurse Consultant
Sydney Adventist Hospital | 185 Fox Valley Road, Wahroonga, NSW 2076
Monday- Thursdayp: +61 2 9847 9433 | f: +61 2 9473 8053 | m: +61 408468470 | e: Holly.Dodd@sah.org.au
http://www.sah.org.au[Description: SAH_EntitySignature2017][Description: Description: 5 moments hand hygiene]
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[Posted with tables on behalf of Dr Claire Rickard – Moderator]
Dear Holly,
The MAGIC guidelines for device selection were published after consideration of duration of therapy, nature of infusate, patient factors and inserter skills. Ideally, all of these things are considered before choosing the first device the patient gets.
I am happy to send you a copy if you email me. Or here is the citation Annals of Internal Medicine 2015 163(6) Chopra V et al. I have pasted the tables below [see attachment – Moderator] for standard patients, and for difficult venous patients (for peripherally compatible infusates).
Healthy wishes,
Clairep.s. Typing 1 handed – please excuse typos/brevity
Kind regards,
Dr Claire Rickard RN PhD FAHMS FACN
Director, Alliance for Vascular Access Teaching and Research
Menzies Health Institute Queensland
and
Professor of Nursing, School of Nursing and Midwifery
Griffith University, AustraliaThanks for the clarification, Holly. I forgot to read the subject!
I am not sure this is the latest version, but my 2016 INS guidelines says this:
I. Short Peripheral Catheters
A. Choose a short peripheral catheter as follows:
1. Consider the infusate characteristics (eg, irritant,
vesicant, osmolarity) in conjunction with anticipated
duration of infusion therapy (eg, less than 6
days) and availability of peripheral vascular access
sites. 1-7 (IV)Not a high level of evidence, but should guide how many PIVC’s you should anticipate before considering other options. Will also depend on your local PIVC resiting policy.
Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]Subject:
Dear Brains trust,
Thank you for all your advice.
I just wanted to clarify, that it is not the number of attempts but the number of PIVCs the patient has i.e 3 PIVC before you consider another form of access for e.g. PICC line.
Holly
Holly Dodd
Infection Prevention and control Clinical Nurse Consultant
Sydney Adventist Hospital | 185 Fox Valley Road, Wahroonga, NSW 2076
Monday- Thursdayp: +61 2 9847 9433 | f: +61 2 9473 8053 | m: +61 408468470 | e: Holly.Dodd@sah.org.au
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