How CVC affects your patients
Clinically, patients with a CVC…
Have 1.5 times greater risk of mortality.
True or False
True
AAM's Daily Homerooms
Name at least 3 things your AAM should discuss during homeroom.
Update the team on Access needs that day: ❑ New Access cannulation, ❑ Which expert cannulator will be assigned ❑ Any changes in needle size used for patients (i.e., 17g to 16g), ❑ Modality transitions ❑ When patient is ready to move to 2 needles (ask the nurse to update treatment order to show AVF/G as only Access in use) ❑ Educate team on new Access innovation (as shared on the AAM National Support Calls), as applicable ❑ Obtain feedback on Access-related issues or progress and ensure documentation is completed by team
Name at least 1 thing a PCT can do to help contribute to access management.
PCTs • Perform Daily Access Checks and make the AAM or nurse aware of any access complications. • Encourage patients to “Look, Listen and Feel” their access for signs and symptoms of problems on their off-treatment days. • Expert Cannulator cannulates new or complicated accesses.
CVC pathway is triggered on Day ____?
Day 1
Clinically, patients with a CVC…
Have 1.7 times greater risk of hospitalization, and spend an average of twenty-seven more days per year in the hospital than those with a permanent access.
True or False
True
What is a Daily Access Check? Name at least 3 things your TM should check on their patient's access site.
LOOK: Elevate the AVF access arm
LISTEN: Use a stethoscope on the entire access to check Bruit
FEEL: Feel the entire access to check Thrill
Name at least 2 things an AAM can do to help contribute to access management.
All Access Manager (AAM) • Be the primary source for all access information and care coordination. • Verify all CVC patients are assigned to an Access Pathway in CWOW and closely monitor progress. • Identify access barriers and coordinate plans for interventions. • Review all CVC patients at Core Team Meetings weekly.
Both step 1 of MOD and CVC pathway gets completed within ____ day?
3 days
Clinically, patients with a CVC…Has a ___ times greater risk for a blood stream infection (BSI).
2.0
3.0
3.5
Has a 3.5 times greater risk for a blood stream infection (BSI)
Vascular Access Complications
B.E.S.T.I.P.S. - what does the acronym stand for
Bleeding Prolonged bleeding is often a symptom of outflow stenosis.
Erosion Wearing away or thinning of the skin “Skin is Shiny” over the area.
Stenosis Narrowing of a vessel which impedes natural blood flow or slows the passive blood flow; pounding pulse or high-pitched bruit; swollen Access extremity when compared to the opposite extremity
Infection Localized in one area or spread systemically
Pseudoaneurysms A collection of “old non-absorbed blood” surrounding the access.
Steal Syndrome Cool, pale skin, or decreased circulation of the Access extremity; poor wound healing
Name at least 2 things an RN can do to help contribute to access management.
Collaborates with facility AAM to monitor patients with CVC and plan for permanent access placement, if appropriate. • Collaborates with Expert Cannulator on monitoring new vascular accesses for maturation and readiness to cannulate. • Escalates access issues to Provider for appropriate interventions. • Keeps access documentation updated in CWOW (orders, BFR, needle size, new access, CVC removals, access events, etc.)
Modality Pathways should be completed in ___ days.
Completed in 26 days or less.
CVCs impact nurse time by adding ____ min.
30 min
36 min
42 min
36 min per patient per month for treatment with CVC
AAM has a checklist - daily activities, weekly, and monthly.
Name an AAM daily activity, weekly activity, and monthly activity to help our patients through their access journey to get an appropriate permanent access placed.
Daily - Dedicated AAM time and daily homerooms.
Weekly - Meet with AAM to review all patients on Access pathways. Review and f/u on care activities.
Monthly- Meet with MD to discuss all pts on Access pathways and barriers that need to be addressed. And outcomes. During FHM.
Name at least 3 things an FA can do to help contribute to access management.
Keep team accountable, listen and partner with AAM, escalate barriers that need support from Medical Director...provide support as needed.
What is the first step in CVC pathway?
Educate patient on permanent access placement.