The Clinical Nurse Specialist Role and its Relevance to Vascular Access: A Canadian Perspective

Highlights

• The adoption of a VA-CNS has demonstrable benefits on organizational and patient outcomes.

• The VA-CNS is a cost-effective option for health systems, demonstrating a positive payback of $417,525 to the organization in a 1-year period.

• This methodological approach to the evaluation of the VA-CNS may be useful for other clinicians in determining the effects and/or cost effectiveness of new positions on patient and organizational outcomes.

Abstract

Purpose: The purpose of this quality improvement study was to examine the impact of a Vascular Access Clinical Nurse Specialist (VA-CNS) on patient and organizational outcomes.

Description of the Project/Program: The VA-CNS role was created and implemented at an acute care hospital in Thunder Bay, Ontario, Canada. The VA-CNS collected data on clinical activities and interventions performed from April 1 to March 29, 2019. The dataset and its associated qualitative clinical outcomes were analyzed using deductive content analysis. Furthermore, a cost analysis was performed by the hospital accountant on these clinical outcomes.

Outcome: Over a 1-year period, there were 547 patients protected from an unwarranted peripherally inserted central catheter (PICC) insertion among 302 patient consultations for the VA-CNS. A total of 322 ultrasound-guided peripheral intravenous catheters were inserted and 45 PICC insertions completed at the bedside. The cost associated with the 547 patients not receiving a PICC line result in an estimated savings of $113,301. The VA-CNS role demonstrated a positive payback of $417,525 to the organization.

Conclusion: The results of this quality improvement project have demonstrated the positive impacts of the VACNS on patient and organizational outcomes. This role may be of benefit and worth its adoption for other health systems with similar patient populations.