Does anyone have any "creative" outcome based goals for their teams besides the routine goals like phlebitis/inflitration rates, infiltration, PICC success rates??? After years of practice these routine goals are not very exciting... Any help would be greatly appreciated....
Assuming you have met your existing goals, and keeping in mind that routine goals are still critical for outcomes, how creative do you want to be? Get everyone on the team certified by AVA/INS, survey your patients on their IV experience and act accordingly, get your facility to have a vascular access consult on the admission orders so patients get the appropriate device from your team or a recommendation for a port/tunneled line, make sure your facility policies are in line with national standards, get your docs to stop suturing lines down, sponsor a IV education program for the floor nurses to improve outcomes. Wow you got me on a roll...
Stephen Harris RN, CRNI, VA-BC
Chief Clinical Officer
Carolina Vascular Wellness
Who is currently performing the insertion of short peripheral catheters - the infusion team or primary care staff nurses? I would strongly encourage a method to assess venipuncture proficiency rates. How is the mean number of venipuncture attempts required to start PIVs in your facility? Studies are showing this to be greater than 2 attempts. This means excessive catheter use and excessive costs and very dissatisfied patients. Do you keep adequate outcome data on all infusion-related complications? I am not talking about just productivity data, but outcome data. It sounds like your are doing this by mentioning phlebitis and infiltration rates. Do you work with your infection preventionist to show your CLABSI rates? How about catheter associated vein thrombosis? All outcomes are best measured in events per 1000 catheter days. That is easier said than done. So if you do not have data calculated like this, I would work toward that goal. Finally do all staff performing any type of venipuncture correctly report both percutaneous needlestick injury AND mucocutaneous exposure of eyes, mouth, nose etc? We do hear anecdotal reports of mucocutaneous exposure but this has not been published yet with peripheral venipuncture. For some reason mucocutaneous exposure is not being documented as it should be or it is such rare occurrence that no one thinks about it. So I would work on any type of vessel preservation project and bloodborne pathogen exposure project such as these. These are high on my list of priorities right now because I gave presentations on both of these issues at AVA last week. Finally I can think of numerous measurements related to IV medication errors, blood transfusion and parenteral nutrition. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
timeliness of service is the new buzz word. from order to implementation of patient serviice is a new measure
kathy kokotis
Bard access