Vessel health and preservation: Vascular access key risk considerations

Abstract

Vascular access is the most common invasive procedure in hospitalized patients, with over 90% requiring intravenous therapy. Despite its routine nature, improper selection and management of acceso vascular devices (VADs) can lead to complications such as infections, thrombosis, and device failure. Preserving the integrity of the vascular system is essential for ensuring safe and effective treatment delivery across healthcare settings.

This paper describes the key principles of the Vessel Health and Preservation (VHP) model, highlighting its implementation as a structured, evidence-based clinical pathway for optimizing vascular access outcomes, preserving vascular integrity, and reducing complications. It also outlines a stepwise approach to vascular access planning, device selection, management, and escalation based on patient-specific factors and risk profiles.

The VHP model is structured around four main stages: assessment and device selection, insertion, management, and outcome evaluation. Key findings and recommendations include early device planning within 24 h of admission and placement within 48 h, daily reassessment to align access with evolving treatment needs, use of clinical pathways to guide device selection based on diagnosis, therapy type, and duration, emphasis on minimizing the number of device lumens, choosing the least invasive device, and using vascular access teams for assessment and the identification of high-risk patients requiring specialty placement and escalation to interventional radiology or surgical teams.

Implementing a VHP program across institutions requires leadership support, interprofessional education, and integration into electronic health records. Adopting this proactive model improves first-attempt insertion success, reduces delays in therapy, and lowers complication rates. In complex cases, timely advancement to specialty placement ensures continued vascular health while maintaining access to essential treatments.