I attended the central line insertion class at AVA last September. This was a wonderful learning experience that I would highly recommend. I am trying to expanded my practice to include this at my hospital. I am willing to start small and take baby steps by just asking to insert Jugular lines. I have done literature searches. The research articles that I have found, have been done in countries other than the US (mainly Australia and the United Kingdom)- including the ones in JAVA. I have the position papers from AVA and INS and lots of other supporting literature. I work at a 300 bed community hospital and I wonder if this process would be easier in a university hospital.
I was asked to get more information including:
-example policies and procedures- I have one from the internet
-examples of hospitals that are allowing nurses to insert central lines
-any articles with research done in US hospitals
I truly feel we need to continue to expand our practice in order to provide our patients the best care we can, especially in today's world. I am asking my fellow "proactive vascular access specialists" to assist me if possible. You can contact me offline line if that works better for you at [email protected]
Thanks,
Juline
Juline,
I have been inserting since October 2011. I work in a small community hospital but have 5 other "sister" hospitals within our regional network. We are just starting to progress in training more RNs from those faciliteis now. You are right about "baby steps". If I can help please email me directly. [email protected]
Darla Tarvin RN VA-BC
Mercy Clermont Hospital
Thanks Darla.
I'm sure this is probably the first hurdle and there will be others, but getting it considered is very challenging and frustrating. However, it is frustrating to us when we are at a patients bedside with our supplies and ultrasound and we have to walk away from the patient. Leaving the patient waiting for a surgical resident to insert their line, especially when we know the resident is scrubbed and in the OR.
Juline DiSilvestro BSN, RN, CRNI, VA-BC, CPUI
Central Access Team Nurse
Inspira Medical Center- Woodbury,NJ
can you tell me what state you are in? I have been told it needed to start with the State Ed dept for it to be placed undr our practice act. I would love to know more about this also.
smahoney
I live in NJ, which is a decision tree state. As Lynn suggested, you need to check with the board of nursing for your state. You should be able to find this information on their web site.
Juline DiSilvestro BSN, RN, CRNI, VA-BC, CPUI
Central Access Team Nurse
Inspira Medical Center- Woodbury,NJ
Scope of Practice decisions are made according to the process identified by each state board of nursing. There are 3 methods - decision trees, declaratory rulings, and advisory opinions. About 39-40 states now use the decision tree model. So go to your specific state board and learn how they make scope of practice decisions, then follow that process. The same would be true for any professon that has a state board for their discipline. 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
So far in my search, I have identified only 24 hospitals in 13 states (AR, AZ, CA, KS, KY, MO, NC, NY, OH, TN, TX, UT, and VA). I received the list of hospitals from a Bard representative which was last updated in 2014. AVA has had classes as part of their annual conference for a couple of years now. I would think that there are more institutions than this, that allow RNs to insert central lines.
Juline DiSilvestro BSN, RN, CRNI, VA-BC, CPUI
Central Access Team Nurse
Inspira Medical Center- Woodbury,NJ
One manufacturer would have information ONLY on the hospitals that purchase their catheters. There are at least 2 other manufacturers - Teleflex and Angiodynamics - that would have customers doing this also. I have never seen a comprehensive list and have not seen anyone from the USA published on their process yet. 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
Thanks Lynn.
I agree that the BARD list probably includes only facilities using their product. Unfortunately, they are the only facilities that have been sent to me. I have reached out to Teleflex, but haven't received a list as of yet. It is a shame that US facilities and nurses doing this process have not published their process and results. The lack of US based evidence is making it more difficult for me and probably others to expand their practice. My facility would like US based evidence which I don't have. It seems like I may have to present this to the research board and proceed as a research project. All of which will slow down the process.
Juline DiSilvestro BSN, RN, CRNI, VA-BC, CPUI
Central Access Team Nurse
Inspira Medical Center- Woodbury,NJ
Hi Juline...
Would you send me the information you have about NY hospitals allowing RN inserted CVCs.
Thank you.
Keely Ralston
Keely Ralston RN-BC, VA-BC, CPUI, RCIS
Hi Keely,
I only have one NY hospital on my list. It is Orange Regional Medical Center in Middletown, NY.
Juline DiSilvestro BSN, RN, CRNI, VA-BC, CPUI
Central Access Team Nurse
Inspira Medical Center- Woodbury,NJ
www.teleflex.com/en/usa/productAreas/vascularAccess/productGroups/centra...
it wouldn't let me put in the link. Teleflex has a map on their site. I googled "nurse insertion central line teleflex" and it came up.