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Vascular advanced practice nurses

Jane H Hartman, John Baker, James F Bena, Shannon L Morrison, Nancy M Albert
PURPOSE: Determine if the pediatric peripheral vascular access algorithm (PPVAA) led to differences in first-attempt and overall peripheral intravenous (PIV) success, staff attempting PIV access per episode and overall attempts and first PIV attempt success by provider. DESIGN/METHODS: A two-cohort pre-/post-implementation comparative design involved pediatric nurses and patients. The PPVAA included four components: a patient comfort plan, PIV grading score, nurses' self-assessed IV access capability and nurse decision to stop-the-line...
March 2018: Journal of Pediatric Nursing
Ann Plohal, Cheryl Dumont, Cathy Perry, Velda Biddix, Diedre B Bird, Teresa Darst, Candee J Eisenhart, Melanie Pugh
As the result of requests from several state boards of nursing, the Infusion Nurses Society (INS) convened a task force to determine whether insertion of central vascular access devices by appropriately trained registered nurses (RNs) should be recommended. The task force consisted of RNs and advanced practice registered nurses with infusion therapy experience in various practice settings. The results are presented in INS' newest position paper, adopted by the INS Board of Directors, September 2017.
November 2017: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
Mary-Josephine Gallagher
Anti-VEGF (anti-vascular endothelial growth factor) agents are useful for a variety of previously untreatable eye conditions; indications for their use are increasing. As this treatment evolved from cutting-edge to mainstream NHS practice, it resulted in a significant increase in appointments for intravitreal (IVT) injections, clinical assessment and follow-up, and hence an increasing challenge to ensure its timely availability to all who needed it. In addressing that challenge, NHS Lothian successfully initiated an advanced nurse practitioner IVT service in addition to its medical IVT service, which has increased its capacity to provide the requisite high-quality care to this patient group...
July 27, 2017: British Journal of Nursing: BJN
Susanne B Conley, Paula Buckley, Lisa Magarace, Candace Hsieh, Lillian Vitale Pedulla
Nearly 3 million central vascular access devices (CVADs) are used in the United States each year. These devices are an important advance in health care and essential to oncology patients. However, CVADs are the most frequent cause of central line-associated bloodstream infections (CLABSIs). CLABSI can be prevented when evidence-based practices are followed consistently over time. Professional organizations establish valid standards and guidelines to guide CVAD practice. This article identifies strategies implemented at a comprehensive ambulatory cancer center to integrate professional evidence-based standards and guidelines for implanted port care into nursing practice at the point of care...
May 2017: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
Bernadette Chevalier, Heather L Neville, Kara Thompson, Lisa Nodwell, Michael MacNeil
BACKGROUND: Pharmacists have made significant contributions to patient care and have been recognized as integral members of the interprofessional team. Health care professionals differ in their opinions and expectations of clinical pharmacy services. Very little has been published about health care professionals' perspectives on advanced clinical pharmacy roles, such as prescriptive authority or administration of vaccines. In 2013, clinical pharmacy services were introduced in a vascular and general surgery ward where a pharmacist had not previously been assigned...
November 2016: Canadian Journal of Hospital Pharmacy
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
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