Preservación de la integridad y salud del árbol vascular: consideraciones clave sobre los riesgos del acceso vascular

IF 1.1 Q4 NURSING

Enfermeria Clinica Pub Date : 2025-07-01 DOI:10.1016/j.enfcli.2025.502302

Nancy Moureau

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引用次数: 0

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 hours of admission and placement within 48 hours, 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.

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维护血管树的完整性和健康：关于血管获取风险的主要考虑因素

血管通路是住院患者中最常见的侵入性手术，90%以上需要静脉注射治疗。尽管其常规性质，不适当的选择和管理的辅助血管装置（vad）可导致并发症，如感染，血栓形成，和设备失效。保持血管系统的完整性对于确保整个医疗机构安全有效地提供治疗至关重要。本文描述了血管健康与保存（VHP）模型的关键原则，强调了其作为优化血管通路结果、保持血管完整性和减少并发症的结构化、循证临床途径的实施。它还概述了基于患者特定因素和风险概况的血管通路规划、设备选择、管理和升级的逐步方法。VHP模型围绕四个主要阶段构建：评估和设备选择、插入、管理和结果评估。主要发现和建议包括入院24小时内的早期设备规划和48小时内的放置，每日重新评估以使获取与不断变化的治疗需求保持一致，根据诊断、治疗类型和持续时间使用临床路径来指导设备选择，强调尽量减少设备流明的数量，选择侵入性最小的设备。并使用血管准入小组进行评估和识别需要专科安置和升级到介入放射学或外科小组的高风险患者。跨机构实施VHP计划需要领导支持、跨专业教育和集成到电子健康记录中。采用这种主动模式提高了首次尝试插入的成功率，减少了治疗延误，降低了并发症发生率。在复杂的情况下，及时推进到专业安置，确保持续的血管健康，同时保持获得必要的治疗。

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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来源期刊

Enfermeria Clinica NURSING-

CiteScore

2.00

自引率

0.00%

发文量

期刊介绍： Enfermería Clínica is a peer-reviewed scientific journal that is a useful and necessary tool for nursing professionals from the different areas of nursing (healthcare, administration, education and research) as well as for healthcare professionals involved in caring for persons, families and the community. It is the only Spanish nursing journal that mainly publishes original research. The aim of the Journal is to promote increased knowledge through the publication of original research and other studies that may help nursing professionals improve their daily practice. This objective is pursued throughout the different sections that comprise the Journal: Original Articles and Short Original Articles, Special Articles, Patient Care and Letters to the Editor. There is also an Evidence-Based Nursing section that includes comments about original articles of special interest written by experts.