INFECTION PREVENTION
Pandemic boosts infusion demands
Securing supplies, adapting treatment and training, and elevating patient and staff
safety and outcomes remain critical elements by Ebony Smith
emergency, surgical or routine care, the goals remain the same – to perform the most effec- tive and safe treatment and improve health, comfort and satisfaction for every patient. Catheter placement and infusion therapy typically require the use of invasive devices. These, of course, pose health risks in care, including potentially dangerous or deadly infections. The ongoing COVID-19 pandemic also creates additional hurdles in acquiring vital supplies and equipment needed for patients.
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So, what kinds of situations may arise when delivering this care? And what are the most useful products and best practices recommended to achieve safe and successful outcomes?
Preventing complications Education and compliance Nancy Moureau, RN, PhD, CRNI, CPUI, VA-BC, Chief Executive Officer, PICC Excellence, Inc, Hartwell, GA, USA, first points to considerable intravenous (IV) device use and issues during care in COVID-19 times.
octors, nurses and healthcare teams make a pledge to “do no harm” to patients. Whether practicing
receiving treatment in or out of the hospi- tal,” she explained. “Two patients of mine receive long-term intravenous treatments and are at higher risk for COVID-19. One of these patients is very careful and compliant with distancing and day-to-day activities resulting in more stability, while the other is noncompliant. The noncompliant patient has experienced multiple hospitalizations and is exposed to greater risk to his health status. Using all the best products to ensure safety and positive outcomes still requires constant education of the patient and caregivers with a goal of optimal health.”
Staff should receive adequate education on
tools and processes in order to benefi t care and patients, Moreau continues. “We know from the published research
Nancy Moureau
“COVID-19 has in creased the number of intravenous devices used during this pandemic surge,” Moureau indicated. “The increasing need for intravenous device inser- tions and crisis management has negatively affected outcomes and the ability to pur- chase better products or apply performance improvement initiatives. Overall, we have seen an increase in device-related complica- tions as a result of COVID-19.” Other circumstances, Moreau observes, are patient choices around treatment and the risk of COVID-19 infection.
“Patients have all been scared, especially those with chronic or genetic disorders, while
that using re ux-limiting needleless connec- tors reduces catheter failure and other com- plications,” she noted. “Education focused on using effective ushing techniques and correct clamping sequences for needleless connectors helps to minimize thrombotic occlusions, but what we have found is that education does not reach everyone and needs to be reinforced over and over. As technol- ogy increases in healthcare, it is necessary to provide evidence-based education to clinicians on how to safely and effi ciently perform management and care of devices used for treatment.”
Specialty teams and technology At Hartford Hospital, part of the Hartford Healthcare system in Hartford, CT, they concentrate on techniques that help lower the risk of complications, maintain devices, and manage costs in care, expresses Lee Steere, RN, CRNI, VA-BC, Unit Leader IV Therapy Services.
“Our goal is to increase fi rst-time insertion success and reduce preventable complica- tions in order to make vascular access devices last longer,” Steere said. “Part of this involves centralizing IV therapy services – including catheter selection, insertion and manage-
22 January 2021 • HEALTHCARE PURCHASING NEWS •
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ment – within a vascular access specialty team (VAST) of experts. As a result, we have decreased our catheter consumption, which can help avoid any sourcing or sup- ply issues that may arise. In addition, our experience has shown this approach can increase patient satisfaction, improve clinical outcomes and reduce costs associated with infusion therapy.”
One problem that can occur and be pre-
vented is a catheter occlusion, addresses Steere.
“Catheter occlusions are a frequent com- plication when it comes to central vascular access devices (CVADs), which unfortunately can lead to delays in therapy and a pos- sible need for line replacement,” he added. More recently, there has been an identifi ed correlation between patients who receive alteplase for intraluminal blood occlusions and development of central line-associated bloodstream infections (CLABSIs). We use the exus TO-6P anti-re ux technology, which helped us reduce CVAD occlusions by 69 percent – a reduction we’ve been able to maintain for fi ve years. In addition, by using the needleless connector as part of our evidence-based technology bundle for peripheral IV catheter (PIVC) insertions, we managed to reduce PIV occlusions to zero.” Both technology and practices have improved the hospital’s care and bottom line, continues Steere. “A study of this model found higher IV success rates, longer dwell times and fewer complications, which translated to an 80 percent reduction in catheter consump- tion and a projected annual savings of $2.9 million,” he indicated.1
“For CVADs, the
Nexus TKO-6P anti-refl ux technology used by Hartford Hospital
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