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Vascular advanced practice nurses

Lori E Harwood, Barbara M Wilson, Abe Oudshoorn
BACKGROUND: Arteriovenous fistulas (AVFs) are the preferred access for hemodialysis (HD) yet they are underutilized. Cannulation of the fistula is a procedure requiring significant skill development and refinement and if not done well can have negative consequences for patients. The nurses' approach, attitude and skill with cannulation impacts greatly on the patient experience. Complications from miscannulation or an inability to needle fistulas can result in the increased use of central venous catheters...
April 2016: Clinical Kidney Journal
Vicki L Sanders, Jennifer Flanagan
UNLABELLED: The purpose of the literature review was to assess the origins of radiology physician extenders and examine the current roles found in the literature of advanced practice physician extenders within medical imaging. METHODS: Twenty-six articles relating to physician assistants (PAs), nurse practitioners (NPs), radiologist assistants (RAs), and nuclear medicine advanced associates (NMAAs) were reviewed to discern similarities and differences in history, scope of practice, and roles in the medical imaging field...
2015: Journal of Allied Health
Kristen M Chreiman, Patrick K Kim, Lyudmila A Garbovsky, William D Schweickert
The intraosseous (IO) access initiative at an urban university adult level 1 trauma center began from the need for a more expeditious vascular access route to rescue patients in extremis. The goal of this project was a multidisciplinary approach to problem solving to increase access of IO catheters to rescue patients in all care areas. The initiative became a collaborative effort between nursing, physicians, and pharmacy to embark on an acute care endeavor to standardize IO access. This is a descriptive analysis of processes to effectively develop collaborative strategies to navigate hospital systems and successfully implement multilayered initiatives...
September 2015: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
Jennifer Campbell
The insertion and maintenance of advanced vascular access devices is increasingly becoming the remit of advanced nurses. Understanding the potential for air embolism as a complication of this procedure, recognising and managing the signs and symptoms, and being able to apply preventative measures, are imperative to enhance patient safety. A range of outcomes can present from air embolism depending on the rate and volume of air entrained, from sub-clinical to death, so the application of expert knowledge and vigilance is essential to minimise risk...
July 24, 2014: British Journal of Nursing: BJN
Melanie Keeler
More than 800 blood cell and bone marrow transplants are performed annually in Canada to treat fatal cancers and rare blood disorders. Central vascular access is fundamental in blood and marrow transplant nursing to facilitate chemotherapy and blood product infusions. A tunnelled Central Venous Catheter (CVC) is the vascular access device-of-choice in the cell and marrow transplant population. Several practice guidelines direct nursing policy and procedure for CVC management and care. CVC insertion and removal guidelines are increasingly relevant given the widening scope of advanced practice nursing...
2014: Canadian Oncology Nursing Journal, Revue Canadienne de Nursing Oncologique
Efstratios Georgakarakos, Christina Bitza, Nikolaos Papanas, Miltiadis Matsagkas, Miltos K Lazarides
Although peripheral arterial disease is prevalent in the primary care setting, insufficient vascular education among nurses and physicians coupled with certain economic constraints undermines treatment efficacy. Moreover, the burden of advanced venous pathology such as posthrombotic syndrome, venous ulcers, and lymphedema remains suboptimally treated. This article advocates the development of a vascular nursing specialty as a means to improving vascular care especially nowadays, when health care providers dictate comprehensive and cost-effective nursing practice and patient management...
September 2013: International Journal of Lower Extremity Wounds
Linda Kelly
Peripherally inserted central catheters (PICCs) are a popular device for long-term vascular access. They were introduced into practice in the US in the 1970s, but only gained popularity in the UK during the 1990s (Gabriel, 1995). Many nurses now provide services for central venous access. To ensure patient safety, it is important that practitioners inserting these devices maintain up-to-date knowledge and ensure evidence-based practice. This should ultimately reduce complication and risk during insertion. The purpose of this article is to offer a guide to safe PICC insertion by providing an overview of anatomy and physiology and focusing on some of the main complications of PICC insertion and methods along with ways of reducing these...
April 25, 2013: British Journal of Nursing: BJN
Ralph L Sacco, Scott E Kasner, Joseph P Broderick, Louis R Caplan, J J Buddy Connors, Antonio Culebras, Mitchell S V Elkind, Mary G George, Allen D Hamdan, Randall T Higashida, Brian L Hoh, L Scott Janis, Carlos S Kase, Dawn O Kleindorfer, Jin-Moo Lee, Michael E Moseley, Eric D Peterson, Tanya N Turan, Amy L Valderrama, Harry V Vinters
Despite the global impact and advances in understanding the pathophysiology of cerebrovascular diseases, the term "stroke" is not consistently defined in clinical practice, in clinical research, or in assessments of the public health. The classic definition is mainly clinical and does not account for advances in science and technology. The Stroke Council of the American Heart Association/American Stroke Association convened a writing group to develop an expert consensus document for an updated definition of stroke for the 21st century...
July 2013: Stroke; a Journal of Cerebral Circulation
Tina Cormier, Ofelia Magat, Suzy Hager, Fanny Ng, Miran Lee
As frontline nurses, we know firsthand the many challenges of renal disease faced by our patients and the impact on their lives and their families. How can we help them cope with their illness? How can we improve their quality of life? How can we prevent the complications inherent to the disease? How do we know we are doing a good job? Where do we start? The purpose of this presentation is to showcase the global management of the hemodialysis (HD) patient. It provides a collaborative and systematic approach to assessing, implementing, evaluating and coordinating the physiologic and the psychosocial aspects of their care...
April 2012: CANNT Journal, Journal ACITN
Marianne S Cosgrove
Adult congenital heart disease, previously considered a rare comorbidity, is increasingly becoming a reality for today's anesthesia providers. Improvements in prenatal diagnosis, sophisticated surgical techniques and equipment, advances in pediatric critical care, enhanced efficacy of cardiovascular pharmacologic agents, and an overall increase in postrepair survival rates have resulted in an estimated population of approximately 800,000 adults with congenital heart disease. Despite successful surgical repair or palliation, these individuals present the anesthesia provider with a multitude of challenges...
June 2012: AANA Journal
Christine L Hull
Calcific aortic stenosis is a common valvular disease, but its pathophysiology remains undetermined and important considerations exist for treatment. Pathophysiology, treatment by the advanced practice nurse, and literature review are discussed in the context of a case study.
March 2012: Medsurg Nursing: Official Journal of the Academy of Medical-Surgical Nurses
Holisa C Wharton
Empirical research has established the fact that the use of oral contraceptives in young women with the Factor V Leiden mutation increases the relative risk of cerebral venous sinus thrombosis. Cerebral venous sinus thrombosis is a rare cerebral vascular injury whose ambiguous presentation contributes to delayed and often-inaccurate diagnosis. This case report presents a 21-year-old White woman with a severe headache who presented to the emergency department and was diagnosed with cerebral venous sinus thrombosis...
January 2012: Advanced Emergency Nursing Journal
T Bein, B M Graf
INTRODUCTION: An increase in ethical conflicts is being observed in the modern intensive care setting, as more complex therapeutic strategies are available and the treatment of old and very old patients is integrated into the clinical routine due to changes in medical options and social epidemiology. Physicians, nurses and families need ethical support to come to a decision about medical treatment when value conflicts are involved. METHODS: The basis of medical ethics is reported followed by a presentation of personal experiences and a reference overview regarding the impact of ethics consultations...
January 2012: Der Anaesthesist
Evan Alexandrou, Margherita Murgo, Eda Calabria, Timothy R Spencer, Hailey Carpen, Kathleen Brennan, Steven A Frost, Patricia M Davidson, Ken M Hillman
BACKGROUND: Nurse-led central venous catheter placement is an emerging clinical role internationally. Procedural characteristics and clinical outcomes is an important consideration in appraisal of such advanced nursing roles. OBJECTIVES: To review characteristics and outcomes of three nurse-led central venous catheter insertion services based in intensive care units in New South Wales, Australia. DESIGN: Using data from the Central Line Associated Bacteraemia project in New South Wales intensive care units...
February 2012: International Journal of Nursing Studies
Lisa Muirhead, Anthony James Roberson, Janet Secrest
PURPOSE: To present the findings of a survey that examined the reason(s) for use of foot care services among homeless adults in a mid-size southeastern city. DATA SOURCES: Data were collected using an 18-item questionnaire. One hundred homeless adults (65 males, 30 females) were asked about their level of foot care use, including under what circumstances foot care services might be used. CONCLUSION: Foot conditions are an important concern among homeless individuals...
April 2011: Journal of the American Academy of Nurse Practitioners
Patricia Branowicki, Margaret Driscoll, Patricia Hickey, Kristen Renaud, Eileen Sporing
The development and execution of a nurse peer review program to evaluate nursing practice associated with significant adverse events has resulted in systemic changes. Descriptive analyses were conducted for 23 peer-reviewed cases involving 41 RNs and 2 advanced practice nurses from 14 specialties over a 4-year period. Thematic analysis revealed four common event categories: assessment and monitoring, team communication, skin integrity, and vascular access. This approach demonstrates the impact of professional nurse accountability for improving the quality of care and may serve as an exemplar for professional practice...
April 2011: Journal of Pediatric Nursing
Alain Ravaud
Targeted therapy for advanced renal cell carcinoma (RCC) has recently expanded the available treatment options for patients with these malignancies. The rapid introduction of novel treatment options into clinical practice within a relatively short time frame has created some new challenges pertaining to adverse event (AE) management in patients with advanced RCC. Accumulating safety data from the pivotal phase III clinical trials of the anti-vascular endothelial growth factor (VEGF) antibody bevacizumab plus interferon, VEGF receptor tyrosine kinase inhibitors (sunitinib, sorafenib, and pazopanib), and mammalian target of rapamycin inhibitors (temsirolimus and everolimus) have served to characterize the toxicity profiles of these novel agents...
2011: Oncologist
Maurizio Gallieni, Mauro Pittiruti, Roberto Biffi
Adequate vascular access is of paramount importance in oncology patients. It is important in the initial phase of surgical treatment or chemotherapy, as well as in the chronic management of advanced cancer and in the palliative care setting. We present an overview of the available vascular access devices and of the most relevant issues regarding insertion and management of vascular access. Particular emphasis is given to the use of ultrasound guidance as the preferred technique of insertion, which has dramatically decreased insertion-related complications...
November 2008: CA: a Cancer Journal for Clinicians
Inez Nichols, Darcy Doellman
Ultrasound-guided placement of peripherally inserted central catheters has been well documented for adults who require infusion therapy. This same technology is surfacing in the pediatric population to improve outcomes when confronted with the challenges of the smaller vascular system and chubbier body shapes. The scope of practice is addressed in coupling peripherally inserted central catheters with ultrasound imaging, and recommendations are identified for the advancement of nursing practice within the field of imaging technology and application...
November 2007: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
Nancy J Gardetto, Karen C Carroll
Despite enormous advances in the medical management of heart disease, heart failure (HF) persists as a leading cause of hospitalization in our elderly. In 2001, the American Heart Association and the American College of Cardiology published Guidelines for Secondary Prevention for Patients With Coronary and Other Atherosclerotic Vascular Disease. The guidelines proactively responded to a growing body of evidence confirming that comprehensive risk factor management and risk reduction improve quality of life and survival, while reducing recurrent cardiovascular events...
October 2007: Critical Care Nursing Quarterly
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