Froedtert & The Medical College of Wisconsin are proud to have a dedicated Vascular Access Team (VAT) — one of the premier VATs in southeast Wisconsin. This special team ensures the highest quality care for patients who require an intravenous (IV) line.
What is vascular access?Vascular refers to the vessels in the body that carry blood. The vascular system is made up of two types of vessels:
- Arteries, which carry blood away from the heart
- Veins, which carry blood back to the heart
Vascular access is the placement of a catheter line (a thin tube) into a patient’s vein to provide treatment or therapy (also called infusion therapy). The catheter — also called an intravenous (IV) line — may be placed in different parts of the body, depending on the type of treatment needed. The types of IV lines are:
- Peripheral intravenous line — peripheral veins are located in the arms and legs. A short peripheral catheter is placed in a peripheral vein when therapy is not expected to exceed six days. The catheter can be inserted at the patient’s bedside.
- Peripheral inserted central catheter (PICC) line — this type of IV line is placed in a larger vein and is used for treatments that may be hard on smaller, peripheral veins, such as a course of chemotherapy, and for long-term treatments that may take many weeks or even months. The majority of PICC lines can be inserted at the patient’s bedside. The PICC line is inserted through a vein in the arm. Using ultrasound imaging for guidance, the tip of the catheter is moved to a large, central vein in the body.
A PICC line may be used for:
- Total parental nutrition (TPN) to provide nutrition when the gastrointestinal tract is not functioning and unable to absorb nutrients the body needs; a nutrition solution is provided through a catheter in a vein (intravenous feeding)
- Long-term antibiotic treatment
- Pain management
- Certain types of chemotherapy
- Hydration therapy to restore fluids to a patient who is dehydrated
Vascular Access TeamThe Vascular Access Team at Froedtert & The Medical College of Wisconsin is composed of registered nurses who are specially trained in infusion therapy. Team nurses are certified by the Certified Registered Nurse Infusion (CRNI®) credentialing program — the only nationally recognized certification program for infusion nursing — ensuring patient safety and positive outcomes. CRNI® credentialing means VAT nurses are highly skilled and knowledgeable in infusion therapy, are dedicated to their specialty and provide the highest quality care. The team is available from 7:30 am to 10:30 pm, seven days a week.
Early in a patient's stay at Froedtert, members of the Vascular Access Team conduct an early vascular access assessment to determine the most appropriate type of IV line needed. The nurses assess the condition of the patient’s veins, the patient’s disease and anticipated prescribed therapies.
Many factors are considered in IV line placement, such as how long the treatment will be needed, the type of therapy and the patient’s preferences. The early vascular access assessment ensures the right type of IV line is used at the right time.
After assessing the patient, Vascular Access Team nurses consult with the patient’s other caregivers to develop appropriate treatment plans. Selecting the proper catheter early in the course of a patient’s IV therapy leads to a safer, more efficient administration of IV therapy with the best possible outcome. If the patient already has an IV line in place upon admission, the VAT will consult to ensure that the line is monitored daily.
Conducting an early vascular assessment often results in a faster start of treatment of IV drug therapies. This, in turn, may result in a shorter hospital stay — and reduced costs — for many patients.
The Vascular Access Team performs many important functions throughout the hospital:
- Performing early vascular access to make recommendations for IV access (using the national Standards of Practice set by the Infusion Nursing Society)
- Inserting IV lines in patients with difficult vein access after two unsuccessful attempts by nursing staff or if staff believe the likelihood of successful line placement is low; this increases patient satisfaction by reducing the number of insertion attempts and associated pain
- Inserting PICC lines at the patient’s bedside
- Troubleshooting obstructed central line catheters
- Monitoring VAT placed PICC lines daily for prevention of line infection
- Gathering and analyzing surveillance data for Quality and Infection Control
- Providing infusion consultation services to enhance the intravenous skills of the nursing staff through bedside teaching for peripheral IV insertion, central line troubleshooting, and consultation on any infusion therapy questions; patients, medical staff and nursing staff may contact the VAT at any time with vascular access questions
- Teaching patients and cases managers how to care for an IV line once the patient returns home
- Communicating and consulting with home health agencies regarding patients with IVs
Author: Marla Fraunfelder
Date: Sept. 24, 2007