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- Title
Opening a Can of Worms: Improving CVAD Function in Home Care.
- Authors
Purvis, Janet; Cleator, Nan
- Abstract
Nurses have a professional responsibility to assess the function of CVADs before using them and to take actions to maximize client safety. A pan-Canadian home care agency identified inconsistent nursing assessments of CVAD function and actions for CVADs with altered function in a region. It was a high priority to develop a policy, resources, and tools to support nurses to meet professional practice standards and properly assess and document CVAD function, to advocate for and take follow-up actions to improve the safety of client care. With an increased awareness of the importance of determining CVAD function, nurses identified two problems: missing information from the inserting facility about the CVAD (tip placement, external length, ease of flushing and blood withdrawal) and a number of CVADs referred for home care with altered function. Nurses encountered difficulties obtaining the necessary information to proceed with safe care and to get problematic CVADs investigated and treated. Changing internal practice without fully comprehending the impact on external stakeholders created challenges with communication and collaboration between practice sectors. Individual discussions with radiology vascular access nurses helped both sectors gain a better understanding of nursing concerns and needs for safe practice. While concerns were identified by home care, the acute care sector voiced concerns about clients being sent back to hospital with malfunctioning CVADs without sufficient information as to what the problems were. A number of joint strategies were implemented to address these issues with communication and collaboration. To date there is an increased awareness about the importance of a properly functioning CVAD in both sectors. It also became evident that communication of necessary information is essential to provide comprehensive CVAD care for the acute care/home care shared client. This work has resulted in a noticeable decrease in missing information about CVAD function and clients with malfunctioning CVADs in home care.
- Subjects
COMMUNICATION; HOME care services; INTERPROFESSIONAL relations; INTRAVENOUS therapy; NURSING; NURSING assessment; PATIENT safety; CENTRAL venous catheterization
- Publication
Vascular Access, 2014, Vol 8, Issue 1, p24
- ISSN
1913-6692
- Publication type
Article