Express Learning Breakout
Michelle DeVries, BS, MPH, CIC, VA-BC™
Senior Infection Control Officer
Access Scientific () : Speaker's Bureau; Becton Dickson () : Speaker's Bureau; Eloquest Healthcare () : Speaker's Bureau; Ethicon: Grant/Research Support (Status: Ongoing), Speaker's Bureau (Status: Ongoing)
Vessel Health and Preservation includes consideration of optimal site selection for vascular access device placement. Imaging Services often is at odds with vascular access teams, particularly when it comes to preferential use of the antecubital fossa for CT contrast studies. Understanding the beliefs and barriers to optimal site selection from the perspective of the emergency room nurses, the CT technologists, radiology nurses, and ultimately the Radiologists can serve as a starting point for championing change. After gaining buy in of these key stakeholders, policy was revised to match the ACR Contrast Manual recommendations for site selection. A quick reference tool for device requirements for imaging studies was made available for the nursing units and a communication strategy established to ensure inappropriate sites were communicated back to the inserting location. Review of site selection prior to and following these updates reveals a substantial shift to upper forearm, rather than strictly antecubital sites and risk control reports for infiltration/extravasation injury are also examined in addition to chart review for final reasons for removal and dwell time. With a policy of clinical indication, optimizing site selection by engaging our access dependent ancillary departments can help ensure continuity of standards to increase successful dwell. This session is a conversational overview of how a community hospital addressed this common issue. Co-presenters include the Director of Imaging Services as well as the Senior Infection Control Officer to walk through one possible approach and discuss how institutional data can be used as a champion for change, ultimately to the benefit of the patient.