A vascular access team's journey to central venous catheter and arterial catheter insertion.

Constance Girgenti, Sheri Pieroni, Teon Smith
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Abstract

Central venous catheters (CVCs) and arterial catheters (ACs) are indispensable tools in modern healthcare, enabling life-saving therapies. However, they carry risks of complications such as bloodstream infections, thrombosis, and procedural mishaps, which impact patient safety and healthcare costs.1 Nurse-driven central line insertion (NDCLI) programs offer a proactive approach to address these challenges by empowering trained vascular access nurses to perform CVC and AC insertions.2 This 4-year follow-up builds on the initial publication, A Vascular Access Team's Journey to Central Venous Catheter and Arterial Line Placement, highlighting first-attempt success and the low-insertion complication rates of an NDCLI program at a community hospital. The program achieved a 91.25% first-attempt success rate and minimal complications, including a single pneumothorax across 812 insertions. Notably, the addition of midthigh femoral peripherally inserted central catheters (MTFPICCs) addressed critical gaps in vascular access for patients with central vessel occlusions, showcasing the program's adaptability and innovation. This follow-up underscores the value of NDCLI programs in improving efficiency, reducing delays, and enhancing patient outcomes. It also explores the potential for expanding the scope of practice to include other advanced vascular access devices. As the complexity of patient care evolves, NDCLI programs represent a transformative model for leveraging nursing expertise in vascular access, fostering collaboration, and standardizing best practices.

一个血管通路小组的旅程到中心静脉导管和动脉导管插入。
中心静脉导管(CVCs)和动脉导管(ACs)是现代医疗保健中不可或缺的工具,可实现挽救生命的治疗。然而,它们会带来并发症的风险,如血液感染、血栓形成和手术事故,从而影响患者安全和医疗保健成本护士驱动中心线插入(NDCLI)项目通过授权训练有素的血管通路护士执行CVC和AC插入,提供了一种积极主动的方法来解决这些挑战这项为期4年的随访建立在最初发表的《血管准入小组的中心静脉导管和动脉导管放置之旅》的基础上,强调了社区医院NDCLI项目的首次尝试成功和低插入并发症发生率。该计划实现了91.25%的首次尝试成功率和最小的并发症,包括812次插入中的一次气胸。值得注意的是,大腿中部股骨外周插入中心导管(MTFPICCs)解决了中心血管闭塞患者血管通路的关键间隙,展示了该项目的适应性和创新性。这一随访强调了NDCLI项目在提高效率、减少延误和改善患者预后方面的价值。它还探讨了扩大实践范围的潜力,包括其他先进的血管通路设备。随着患者护理复杂性的发展,NDCLI项目代表了一种利用血管通路护理专业知识、促进合作和标准化最佳实践的变革模式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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