Implementation Science and Research

Concurrent Education Session - 60 minutes

2102 - Peripheral Vascular Access Device Infection: An Urgent Patient Safety Issue

Primary Speaker(s)

• 

  Marcia Ryder, PhD, MS, RN

  Research Scientist
  RyderScience, Inc.
  Brentwood, Tennessee

  Nothing to disclose

Moderator(s)

• ML

  Martin Levesque

The success of most medical acute and chronic life-sustaining therapies across all ages and patient populations is dependent on reliable vascular access. Though critical to the provision of life-saving medical therapies, vascular access devices (VADs) are associated with significant risk. Under-reported, under-recognized, and most often ignored, are the infections associated with peripheral vascular access devices (PVADs), such as short peripheral catheters (SPC) and midline catheters (MC).

From 2008 to 2011, hospitals across the nation made significant progress in preventing CLABSI, achieving ~50% reduction in those three years. However, national SIRs have remained relatively unchanged between 2011 and 2016 despite concerted efforts. HHS expects that hospitals will decrease CLABSI rates by an additional 50% by the year 2020. If IPs cannot identify unrecognized risk factors such as PVAD-BSI that contribute to the flat line in progress, this task may be insurmountable.

Consider the answers to these questions: Do you know your institution’s PVAD incidence rate for BSI? How many of your CLABSI are PVAD-BSI? How do you diagnose PVAD-BSI? Will clinically indicated SPC site changes increase the risk for SPC-BSI and what are the legal implications? Have you considered that non-sterile insertion of SPCs may increase BSI risk? Have you considered the lack of sterile SPC insertion as a legal liability when all other VADs are inserted with sterile technique? Do we want to continue to ignore the risk of perpetuating antibiotic resistance by the increasing need to treat the very devices we use to treat non-device related infections? Is the use of MCs to avoid CLABSI in the best interest of the patient?

The answers to these questions and more will be addressed in this session by two experienced presenters: a vascular access researcher and an attorney with specialization in vascular access litigation.

Learning Objectives:

• Re-evaluate the potential patient safety risks of failure to monitor and assess peripheral vascular access devices (PVAD) (short peripheral catheters and midline catheters).
• Consider the implications of PVAD Bloodstream Infections (PVAD-BSI) on Healthcare Acquired Condition (HAC) scores, patient satisfaction, and pathogenesis-based prevention strategies.
• Identify the growing and under-appreciated malpractice risks surrounding PVADs and develop risk management strategies which meet the standard of care and can mitigate liability.