DEVELOPMENT OF AN INTRAVENOUS ACCESS TEAM...

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Kerry Taliaferro CNC Intravenous Access Team Canberra Hospital ACT AVAS ASM 2017 DEVELOPMENT OF AN INTRAVENOUS ACCESS TEAM CREDENTIALING PACKAGE

Transcript of DEVELOPMENT OF AN INTRAVENOUS ACCESS TEAM...

KerryTaliaferroCNC

IntravenousAccessTeam

CanberraHospitalACT

AVASASM2017

DEVELOPMENT OF AN INTRAVENOUS ACCESS TEAM CREDENTIALING PACKAGE

Financial Disclosures

1.DisclosureofRelevantFinancialRelationships

Ihavenofinancialrelationshipstodisclose

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Canberra Hospital & Health Services

Acutecareteachinghospital

600inpatientbeds

ServicesACT&SouthernNSW

Providesspecialistandacutecaretomorethan500,000people

IVATestablished2014

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IVAT AIM

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Recruitandtrainnewstaff

Qualifiedcompetentpractitioners

Developacredentialingpackage

What we had...

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How to go from here....

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To finding a plan

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Australian credentialing programs

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International Programs

PICCACADEMYNETWORK(PAN)• TraintheTrainer• 40• Expense• RecognitioninAustralia

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International

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WoCOVA evidence based consensus

• StandardminimalrequirementsfortrainingonCVAD’s

• 16recommendationsaskeytoensuringsafeandcompetentpractice

• Standardiseeducation

• Simulationpractice

• Supervisedinsertions

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The Basics

• A&P• Ultrasound• CVADknowledge• Infectioncontrol&SurgicalANTT• Deviceselection• Insertionmethods• Troubleshooting• CareandMaintenance• Proficiencyandcredentialing

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Adult learning methods

• Experientiallearning• Integrationofknowledge,activityandreflection

• Experientialeducation• Takeintoaccountlearnersknowledgebase/experience

• Situatedlearning• Active/guidedparticipationthroughapprenticeship• Communityofpractice• Student– Mentor

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Situational Learning

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Offer Variety

• Facetoface

• Elearning

• External

• Internal

• Simulation

• Handsonsupervised

• Formalobjectivecredentialing

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The Learner

• Gainknowledge,skills,competency

• Establishedrequiredstandards

• Achieveidentifiedoutcomes

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The Trainer

• Defineneeds

• Setobjectives

• Communicate

• Monitorprogress

• Feedback

• Encourage

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CredentialingCriteriaforPICCInsertionsforIVATmembers

PreRequisites

CompetencyAchievedin

SuccessfulapplicationtoIVATRN2role

Venepuncture andbloodcollection

Intravenouscannulation

TrainingduringIVATRN2roletoachievePICCinsertioncompetency

AttendonedayUltrasoundguidedPICCinsertionworkshop

Completethesee-learningprograms

Consent

Aseptictechnique

CVADCareandmaintenance

PatientidentificationandProcedurematching

Scrubbinggowningandgloving

OneononelectureonCVAD’sandUltrasoundguidedaccesswithIVATCNCandStaffspecialistICU

SupervisedPICCinsertionswithIVATCNC– until

PassIVATCVADinsertionandcareexam

FormalClinicalCompetencyofprocessfromreferraltocompletedinsertionandfollowup

OrientationtotheIVATRN2role

VascularAccessDeviceSelection,InsertionandManagementOnlineCourse(CourseCost:$50.00- optional)

UltrasoundforPeripheralAccessTrainingCourse

Sherlock3CG*TipConfirmationSystem(TCS)TrainingCourseandcompetency

Completeelearning programsathttps://www.bardaccess.com/clinical_training/login.php

MaintainInsertionSkillsReassessmentEvery3years

DIVISIONOFMEDICINEExecutiveDirectorofMedicine

DirectorofNursing

AmbulatoryServicesAssistantDirectorofNursing

INTRAVENOUSACCESSTEAM

IVATCNC

NHSQSTANDARD3.9.1:INVASIVEDEVICES STANDARD3COMMITTEE

Scrubbinggowningandgloving/SurgicalANTT/ECGTCSPracticalassessment Obtain

Ultrasoundguidedaccesstrainingandcompetency

TraininginECGTCS

IVATRN2

Pre requisites

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elearningInternal External

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Training for IVAT RN 2 role

• OrientationtoIVATRN2role• AttendexternalonedayUltrasoundguidedPICCinsertionworkshop

• OneononelecturesonCVAD’sandUltrasoundwithCNCandStaffspecialistICU

• S,G&G/SurgicalAseptictechniquetraining

• SupervisedPICCinsertionswithCNC

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Assessments

• S,G&G/Aseptictechnique>Practicalassessment• FormalClinicalCompetencyofprocessfromreferraltocompletedinsertionandfollowup• PassIVATCVADinsertionandcareexam

• MaintainInsertionSkills

• Reassessmentannually

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Competency

• Skills• Knowledge• Attitude

• Valid• Reliable• Fair

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Competency based assessment

Fourdomains• ProfessionalPractice

• CriticalThinkingandAnalysis

• ProvisionandCoordinationofCare

• CollaborativeandTherapeuticPractice

ArandaS,YatesP.Competencyassessmenttoolformanagementofcentralvenousaccessdevices(CVADs).Canberra:TheNationalCancerNursingEducationProject(EdCaN),CancerAustralia;2009.

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CATEGORY / LEVEL

• Knowledge• Comprehension• Application• Analysis• Synthesis• Evaluation

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PERFORMANCE LEVEL

COMPETENTEstablishedcompetenceasaspecialistwithintheirclinicalfieldofpracticeCOMPETENTBeginningcompetenceasaspecialistwithintheirclinicalfieldofpracticeNOTYETCOMPETENT

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Written exam topics

• Anatomy&Physiology• Patientassessment&deviceselection• Insertion• Documentation• Complications• Management• Scenarios

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Competency

• Certificate• Capabiliti record• 40hrsCPD

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Participants Perceptions

Did you attend an Outside (Industry) PICC study day prior to starting with IVAT

•Yes=3

•No=1

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Responses

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CVAD SKILLS

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RankedEasiest(1)toHardest(10)

Averagerank

Lowestranked

HighestRanked

Ultrasound Skills

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0

0.5

1

1.5

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2.5

3

3.5

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4.5

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HoldingtheProbeSteady

Identifyingvessels/nerves/structures

AccessingveinsforPICCinsertion

AccessingveinsforPIVC

(cannula) insertion

Identifyingtheneedletip

RankedEasiest(1)toHardest(5)

AverageRank

LowestRanked

HighestRanked

Did you undertake independent research for the exam?

Yes=3No=1• Hospitallibrary• Generalanatomyfromtestbooks• Hospitalpolicy• Intravenousaccessjournals• BARDonlinearticles

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Time to confident insertion

• 5weeks

• 6weeks

• 8weeks*

*parttime

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Confidence level

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Knowledge level

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10

20

30

40

50

60

70

80

90

100

Lowestranking Highestranking Averageranking

HowwouldyourateyourknowledgeofCVAD'sonascaleof1to100(100=expert)

BeforeTraining Aftertraining

Validation

• NHSQSAccreditation2105• Standard3HAICommittee• SDU- Capabiliti• EducationActivityReport• RegisteredVET

• ValidationbyexternalPICCCNC

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Future directions

• PAN??• Collaboration!

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I acknowledge the support of an ACT Health Nursing and Midwifery Travel Scholarship to attend this conference and present to you today

Thank you!