Editorial Type:
Article Category: Research Article
 | 
Online Publication Date: 07 Mar 2024

Impact of a Vascular Access Specialty Service on Hospitalized Pediatric Patients: A Pilot Feasibility Study

DNP, RN, CPN, VA-BC,
PhD, RN/DABAT,
MSN, RN, CNS, CPEN, VA-BC,
BSN, RN, CPEN, and
DNP, APRN, NNP-BC, FAANP, FAAN
Page Range: 8 – 34
DOI: 10.2309/JAVA-D-23-00028
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Highlights

  • Our project implementing a VAST produced these improved outcomes.

  • There were 31% fewer IV devices.

  • There were 22% fewer needle sticks.

  • There were 49% reduction in delays.

Abstract

Background:

Vascular access is essential in the care of hospitalized pediatric patients. Planning and device selection are important for optimal patient outcomes. Vessel preservation is critical for pediatric patients.

Purpose:

To determine and evaluate the impact of a vascular access team on pediatric patient care.

Methods:

A vascular access specialist team (VAST) was implemented on one medical unit at a tertiary children’s hospital, 16 hours a day for 4 weeks.

Data Analysis:

Descriptive statistics were used, including (a) first-stick success rates, (b) number of needle sticks and vascular access devices per hospital stay, (c) delays in therapy, and (d) frequency of topical analgesic use. Preintervention data were compared with postintervention data. Qualitatively, nursing and medical staff were surveyed to evaluate their perception of project experiences.

Results:

Compared with preintervention data, 56% fewer peripheral intravenous lines were initiated, and 31% fewer total vascular access devices were used during the hospital stay. There were 22% fewer needle sticks per peripheral intravenous line attempt. The first-stick success rate of the VAST was 71% compared with the bedside nurse rate of 52%. There was a 78% reduction in time between devices/1000 patient-days/week, representing reduced interruptions in therapy. The use of topical anesthetics for intravenous device placement increased 333%.

Conclusion:

This project provided clarity regarding the value of the VAST for pediatric hospitalized patients. The VAST model is evidence based, follows best-practice guidelines, is fiscally sound, and optimizes nursing practice and quality patient care.

Keywords: IV team; vascular access; pediatric vascular access; infusion team; vascular access planning
Copyright: Copyright © 2024 Association for Vascular Access. All rights reserved.
Figure 1.
Figure 1.

Patient assessment within 12 hours of admission. EHR = electronic health record.

Figure 2.
Figure 2.

Number of peripheral intravenous lines started on 4 East and 2 Rose per 1000 patient-days.

Figure 3.
Figure 3.

Total number of vascular access devices/1000 ­patient-days.

Figure 4.
Figure 4.

Peripheral intravenous line success rates.

Figure 5.
Figure 5.

Needle sticks per peripheral intravenous line ­attempt.

Figure 6.
Figure 6.

Time in hours between devices/1000 patient-days/week.

Figure 7.
Figure 7.

Percent use of topical anesthetics per peripheral intravenous line placed in medical.

Contributor Notes

Correspondence concerning this article should be addressed to dholt@apu.edu
Received: 21 Oct 2023
Accepted: 30 Nov 2023
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