Venous Access – A Crucial Nursing Skill

Venous access, the process of gaining access to a patient's vein is a critical skill necessary for basic patient care in both the hospital and amb…

Venous access, the process of gaining access to a patient’s vein is a critical skill necessary for basic patient care in both the hospital and ambulatory care settings. There are several different common venous access devices (VAD) and examples of each are listed below.

Peripheral IV – These devices are ideal for short-term access (no more than 72 hours in the same site). The majority of short term situational needs can be meet with a conventional PIV line. Depending on the situation, veins can be accessed in the hand, arm, foot, or head.

Peripherally Inserted Central Catheters – PICC’s are commonly inserted in either the basilic, brachial, or cephalic veins and many facilities utilize skilled nursing teams to insert them. Common uses for these insertions are for repeated blood transfusions, parenteral delivery of nutrition, antibiotics, analgesics, and chemotherapy.

Centrally Inserted Catheters – The three main types of centrally inserted catheters are listed below:

Non-Tunneled Catheters – used for short term time frames in an emergency department, operating room, or intensive care unit. Many health care organizations utilize skilled nursing teams and comprehensive barrier controls.

Skin-Tunneled Catheters – Used in situations where the catheter will need to stay inserted for longer period of time. Regular infusions of medication or blood are potential examples. Again, skilled staff and protective measures are needed for successful insertion.

Implantable ports – Consists of a catheter attached to a reservoir that is implanted into a surgically created pocket on the chest wall. These devices are expensive, difficult to insert, and time consuming to remove.

It is important to note that there are no “infection or complication proof” venous access devices. There are inherent levels of risk and health care teams and patients should function accordingly. Patient education can help nursing teams identify complications earlier as patients will be able to notice developing issues.

IV insertions and infusions are among the most common hospital procedures performed in health care facilities around the world. As such, it is easy for health care providers and organizations to simply assume that they are doing the best that they can. Complacency is unacceptable – health care providers must consistently seek out the most current evidence based IV therapy information in order to continue to provide quality patient care.

Even though there are a number of online IV therapy CE providers, real world bedside training of nurses remains the key. Regular training consisting of evidence based material reviews and practical hands-on learning are essential to maintaining an evidence based nursing culture.