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Anne Marie Frey
Help! What statistics do you keep??? AND Happy IV Nurse's Day!

HI, all, and Happy IV Nurse’s Day!!!!

     We are trying to revamp our data collection system at Children’s of Philadelphia….right now, we are doing a daily log on paper, collecting numbers of PIVs, attempts, complications, and reason for PIV, and some CVC activity [insertion, complications, repair, port access, etc.]  This log data is manually transferred onto an EXCEL spreadsheet.  As you may guess, this is extremely time consuming, and cumbersome.  Some of our hand collected data is also redundant now, as most of our CVC activity is pulled from EPIC by a data person, who collates the CVC  information monthly and reports it. 

     The group revamping our data monitoring system is asking me what data we are “required” to collect, particularly on PIVs,  to be compliant with national standards, such as INS, JCAHO, etc.   I am having great difficulty finding anything written that says specifically, “you have to keep data on this aspect of infusion nursing”.  The INS standards talk about phlebitis and infiltration, and extravasation, which we currently keep, but again, on paper.  Plus, I don’t want to just be monitoring tasks;  we should be looking at positive outcomes as well.  So any help would be appreciated.

 

MY QUESTIONS FOR THE GROUP ARE:

 

Does anyone know absolutely what data do you have to maintain on PIVs? CVCs? Other activities [pt. education]? 

 

What governing body do you use as a guideline for what data you should collect?

[JCAHO, INS, etc.]

 

THANKS IN ADVANCE!!  Anne Marie

Ann Williams RN CRNI
I won't be answering your

I won't be answering your question, but will say that for the almost 19 years in a hospital based Home Infusion, and the 6 as head of an IVT prior to that, I tracked numerous complications of Central lines, but have mainly reported the infections to the higher ups.  This has always kept the accreditors happy.  That being said, I also don't track the PIVs, but mainly because we have very few in the home, and the ones we have are very short term.  Sorry this doesn't really address your question, but hopefully it might help in some way.

Ann Williams RN CRNI

Infusion Specialist

Deaconess Home Infusion

Evansville, IN

Constance
We all collect data and lots

We all collect data and lots of it! How does all that data impact our patients and our speciality? Lets start thinking globally and collect the same data in one data collection tool. Check out the national PICCREGISTRY.COM from here data will have an impact!

[email protected]..
Data

Hi Anne Marie,

 

We get this question at least once per week from the infusion and vascular access specialty.  That is why the team at CVAD Resources developed the first ever national database for PICCs.  The PICC Registry was launched in January of 2013.  Because of the success of the PICC data collection tool, we are adding data collection for CVCs and IVs.  The questionnaires for both the CVC Registry and the IV Registry are complete and we are in the middle of actually integrating the two databases into the PICC Registry.  These will function as three distinct regsitries so if a clinician is an IV specialist and does not place piccs, etc., they can use only the registry that applies to their practice.  We collect data specific to pediatrics as well - as have added neonatal data for PICCs.

 

We have 12 quality reports for the PICC Registry and we will utilize some of the same reports for the CVC Registry and the IV Registry.  A clinician receives real time reports as an individual clincian compared to to your team, health system and the nation.  The team lad sees all data but each clinician only sees their own practice with the comparisons.  This is how outcomes will improve across a practice , a team and the entire specialty of vascular access.  DATA is the key for moving your pratice ahead in today's world and can be used for so many aspects of care.

 

I would love to speak with you further about your ideas and to see if we can work together on the IV Registry.  Please feel free to reach me at [email protected] and I can give you a call to discuss further. 

 

Chuck Sherline

CVAD Resources

Chicago, IL

 

kathykokotis
data

Mandatory reportable data and data liability collection differ

Mandatory data would include the following

CLA-BSI rate ICU (NHSN, CMS) - need catheter dwell days

Pneumothorax (CMS) now a never event and I would keep this data for all central lines including a PICC which is a central line.  This shows the differnces in central line types and is reportable.  I would also include dialysis

Air Embolims (CMS) now a never event and I would keep this data for all central line including a PICC which is a central line.  I would also include dialysis

The above are the only mandatory reportable data points I can find

This brings us to outcome which are not mandatory but may be needed from a legality standpoint 

I would review the chapter on documentation in the Infusion Nursing evidence based approach for a guide

Kathy Kokotis

 

Robbin George
I wish someone would please

I wish someone would please answer Anne Marie's question-Specifically as it applies to Peripheral IVs

We are trying to make a case for better PIV monitoring particularly as it applies to Phlebitis and the subject of PIV-CR-BSI

We too use EPIC and are unable to monitor and data collect using the tools provided

We have been asked why it is important and how to improve the process

Thank You Robbin George RN VA-BC

Robbin George RN VA-BC

lynncrni
 The answer depends on the

 The answer depends on the laws in each state. Many states mandate public reporting for hospital acquired infections but not all states require this. In those states with this mandate, hospitals and other healthcare agencies participate in the NHSN from CDC. This requirement is limited to CLABSI. 

You also have to know what hospital acquired conditions are occuring so that these from the CMS list will not be billed to CMS. This includes vascular catheter infections (all types not just CLABSI and not just CVADs), pneumothorax from CVAD insertion, vascular air embolism, and blood incompatibility. This does not require calculation of rates. 

All other complications are no mandatory. However if you ever hope to improve patient care, and patient satisfaction, you must know the current rates of phlebitis, infiltration/extravasation, nerve injuries, etc. in order to create QI processes. 

CDC, INS, Joint Commission are NOT mandatory or required by any laws or regulations. However, these form the structure of what is considered best practice and these documents are certainly used to measure the practices in your facility especially for a lawsuit. 

Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

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