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VAS Nurse placing IJ, EJ, and Femoral Central Lines

 I'm reaching out to find out what hospitals are allowing the vascular access nurses to place central lines in the IJ, EJ or the femoral areas for research purposes.  Any information is helpful, thanks so much for your help.  

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clarification

 Sorry,  I meant to say the information is for research purposes not the line placement :)

 

Christin Dillon RN VA-BC

Juline
What type of research?

Is this for a work related research or a research project for school. I did a research paper on this subject for school and would be happy to share my references with you.

Juline DiSilvestro BSN, RN, CRNI, VA-BC, CPUI
Central Access Team Nurse
Inspira Medical Center- Woodbury,NJ

Juline
Facilities allowing nurses to place central lines

Hi Christin,
I looked into this earlier this year hoping it would help me to be able to do this at my facility, it didn't. I have hit many road blocks and am at a dead end for now. I will be trying again. I am waiting for an incident or opportunity to prove we could make a difference occur. I have to pick the right time with the right people.
Here is what I have gathered as of the beginning of this year. It is concerning central line insertions other than PICC lines. They may be more. Good luck in your research.

List of U.S. based facilities with Registered Nurse governed CVC Programs
Banner Baywood, Phoenix, AZ- 340 beds—since 2012
Banner Thunderbird, Phoenix AZ- 111 beds
Carolina Vascular Wellness, Durham, NC
Chesapeake Regional, Chesapeake VA- 310 beds- all CVCs and A lines since 2009
Corbin Baptist Corbin, KY
Harris Methodist, Dallas, TX
Harris Methodist, Fort Worth, Tx
Hughley Medical Center (Texas Health Resources) Dallas, Texas
Intermountain Health Care, Murray Utah
Kaiser San Diego Medical Center, San Diego, (>2 years)
Kennedy University Hospital, NJ (>2 years)
Lomalinda University Medical Center, Lomalinda CA
Longview Texas (Dwayne)
Mercy Hospital Clermont, OH- 90 beds, 16- ICU; since Oct 2011
Middle Tennessee Medical Center, Murfreesboro, TN
Mission Hospital, Ashville, NC (1 year)
Ogden McKan Dee Hospital, Ogdon, Utah
Orange Regional Medical Center, Middletown, NY
Presence Health, Joliet, Il
Pomona Valley Hospital Medical Center, Upland CA
Riverside County Regional Medical Center, Moreno Valley, CA
St. Joseph Medical center, Sacramento, CA (1.5 years)
St. Joseph’s Healthcare System, Emerson, NJ
St. Luke’s Hospital, Kansas City, MO (>5 years)
University of Arkansas, Little Rock (>5 years)
Vanderbilt Medical Center, Nashville, TN (7 years)
Via Christi, Wichita, KS- 700+ beds (> 2years)

27 hospitals in 15 states- AR, AZ, CA, Il, KS, KY, MO, NC, NJ, NY, OH, TN, TX, UT, VA
Scope of Practice in 47/50 states

Juline DiSilvestro BSN, RN, CRNI, VA-BC, CPUI
Central Access Team Nurse
Inspira Medical Center- Woodbury,NJ

daylily
Juline,

Juline,

I'm licensed in NY and was unaware of NY allowing RN inserted central lines.  Please help clarify the information you received regarding orange regional medical center in Middletown, NY placing central lines.

Thanks:)

 

JackDCD
Nurse led CVC programs

Hi Juline,

Still haven't been able to work your magic?...Keep plugging away. NJ is a Decision Tree state so if it's in your scope, you can do it. There is a general reluctance in Nursing to NOT be a standout. Play it safe, don't do anything that makes you step from your comfort zone. Hence, nursing practice has been pretty much unchanged forever. I believe though, it's the nurses that are not afraid to step into the light that will move this field forward. So, you keep plugging

 

Jack

Juline
Still plugging!

 Hi Jack,

Good to hear from you. Haven't given up yet. Just waiting to pounce on an opportunity. Timing is everything. A recent change in nursing leadership and the lack of a physician champion is current hurdles. Nursing leadership change not a problem- just giving some time for that. I have gotten to the point of the research committee. Looked good and then they decided it needed to go through the medical committee since it is a change in practice. Need a physician champion for that. 

The physician champion is what I am waiting for the opportunity for. We do not have a IR physicians that inserts lines.  ER docs rarely insert other than emergency-they call surgical resident. As of this week, my facility just started having intensivists in the ICU that insert central lines with and without ultrasound. Already started working on a collaborative relationship with the "Fellow" with PICC lines for his patients. Work with the Fellow, and hoping to develop a true collaborative practice with the Fellow to expand to the Attending. Working on that relationship now and then will see where I can take it. 

Always thinking and keepings eyes and ears open for the opportunity.

Juline DiSilvestro BSN, RN, CRNI, VA-BC, CPUI
Central Access Team Nurse
Inspira Medical Center- Woodbury,NJ

[email protected]
cdillonrn@gmail.com's picture
 Well, we did pass the policy

 Well, we did pass the policy through the Med Exec committee and it just needs final processing from another committee for wording and such-------Bard is coming in August to teach the Power Hohn and I have already been through a CVC class and placed a couple.      We really didn't have any resistance, the docs were very receptive and we have been blessed with several champions that are helping us with this project.  We are heading to AVA in September and will go through the cadaver lab workshop too.  I work for two other hospitals prn on the vascular access team and we certainly don't have this much support and the docs just won't let it go.                                                                            

 

Christin Dillon RN VA-BC

lynncrni
 Congratulations!! This is a

 Congratulations!! This is a good example of the many differences in the culture of each facility. We have to keep working on a partnership model with the MDs to expand our practice but some just want go there at all. I heard recently from a hospital that is just now having their radiologist agree to give up PICC insertion for a nursing team. 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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cdillonrn@gmail.com's picture
 Thanks Lynn, we really feel

 Thanks Lynn, we really feel like we are being recognized as a professional vascular access team, there wasn't one doc that showed resistance--most of them wanted to know when we could start and if we would do it 24/7.... :)

 

Christin Dillon RN VA-BC

Juline
That is great. I haven't even

That is great. I haven't even made it to med exec yet since we don't have a doc to mentor us. However, as I mentioned the intensivists starting in the ICU, my opportunity came up yesterday. A very difficult case that the intensivist attending wanted to discuss with me. Which lead to an open and collaborative discussion with mutual respect for each other knowledge and skills. (Perfect timing for me). He has offered to teach and mentor me for CVC insertions. Even asked how many I will need and so forth. It only took me one week of him being there to get him to help. Even I didn't think it will be that fast. Time for me to start this process again. I guess I need to present this to my boss again.

I also went to a class last year at AVA and the cadaver lab. The cadaver lab was the best conference ever. It will really be rewarding. Hope you enjoy it as much as I did. I will also be going to AVA again this year. Maybe we can meet up to exchange stories.
I would like to discuss with you what determined your choice of manufacturer to use. I am torn between two for different reasons and would like to know what your experience was. My email is [email protected] if you want to contact off this website.

Thanks,

Juline DiSilvestro BSN, RN, CRNI, VA-BC, CPUI
Central Access Team Nurse
Inspira Medical Center- Woodbury,NJ

[email protected]
cdillonrn@gmail.com's picture
 Awesome Julie, that's good

 Awesome Julie, that's good to hear...I' m a little new to this hospital and until we were bought by another hospital system there wasn't near as much support with the IJ, the new Chief medical officer has become my new best friend :)  His take on it is, why take up the doctor's time when there are specialized vascular nurses that can place lines and then the doc can do what he does best... He has been a rock and I'm grateful for the chance we have been given....yes...would love to talk with you at AVA, I'm taking my coworker with  me and this is her first time so she will be thrilled to meet with you as well, I will email you our info, thanks again, Christy 

 

Christin Dillon RN VA-BC

Liz Donnellan
Why limit yourself to IJ

Why limit yourself to IJ placements?  Seek out your local Arrow rep/nurse educator.  After all, Arrow does hold the CVC market share.

[email protected]
cdillonrn@gmail.com's picture
 Update....since the Med Exec

 Update....since the Med Exec Committee approved our policy I have successfully placed 3 IJ lines on the first try and have been scouting around waiting for the next opportunity....the physicans are so supportive.  

 

Christin Dillon RN VA-BC

jill nolte
You go girl!

So proud of you and your team! 

JackDCD
Way to go Christin.....that

Way to go Christin.....that is surely encouraging. What hospital are you practicing in?

 

 

Jack Diemer

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St Joseph Medical Center in

St Joseph Medical Center in Kansas City, MO.  Love the docs here and all their support :)

 

Christin Dillon RN VA-BC

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 Just an update, we have

 Just an update, we have placed 6 IJ's on the first stick with %100 success rate and the docs that were a bit squeamish have come around to be one of the most supportive, thanks for all your encouragement.  :)

 

Christin Dillon RN VA-BC

Tyoungman
CVC placement

Hi Christy,

I am just seeing your post for the first time, Congrats! My team is made up of 2 full time RN's, we place PICC's and Centrally placed Central Catheters M-F 7A to 7P. We place about 275 IJ CVC's annually and about 600 PICC's. Please send an update with how you are doing, I am actively trying get more nurses involved.

Tim

 

 

Tim Youngmann RN

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cdillonrn@gmail.com's picture
  Hi again, as of today we

  Hi again, as of today we have placed 55 IJ lines with no compications of pneumos or carotid sticks.  There were only a couple we could not get to thread to the SVC and had to use other resouces but that will  happen with certain paitent populations.  There are only 2 of us that place the IJ lines and we only have 12 hour shifts all week long.   Looking forward to starting the aterial line policy and procdure soon :)

 

Christin Dillon RN VA-BC

JackDCD
 Nice Job!!

 Nice Job!!

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