ALL CARE

DELIVERED NEEDS

TO BE EVIDENCE

BASED.

• Research

1 STEP

• Publication

2 STEP• Change in

practice

3 STEP

• SAFEST/BEST CARE POSSIBLE

GOAL

SO MANY INFORMATIONS AND SO LITTLE TIME!!

RCN

INS

AVA

WEB SEARCH :ATHENS,

PRACTICE

EDUCATION

ORGANIZATION/ STRUCTURE

Assessment and Device Selection

Client Education

Documentation

All clients requiring vascular access,

regardless of the duration of therapy.

RCN recommends the use of structured

approach and the development of a

vascular access care plan prior to the

initiation of therapy .

Prescribed therapy

Duration of therapy

Physical assessment

Client health history

Supporting system/resources

Device availability

Client preferences

Prescribed therapy

PH and Osmolarity

Frequency of blood sampling

Type of therapy

ACID

NEUTRAL

ALCALINE

The concentration of particles dissolved

in each solution .

In human plasma, the concentration of

dissolved paricles is about 290x10(3)

A PH outside the range of 5-9 and/or

osmolarity greater than 500 Mosm/l

should be administered with a suitable

central venous device

Maki(1991) :27-70 % of patient receiving

peripheral infusion therapy develop

phlebitis

The incidence of phlebitis rises

progressively with increasing length of

cannulation.

30%

39-49%

70-88%DAY 2

DAY 3

DAY 4

Mercer Ward ( oncology/haematology

and respiratory)

30 beds

December 2008 :12 patients with length

of stays between 7-15 days

11 patients on some forms of IV therapy

Vascular assessment and device

selection: RNAO , 2007

RCN” Guidelines for Intravenous

therapy”,2005

L.Doherty “ care and management of

central line catheters”,2006