Very excited to finally have a green light develop a vascular access team for our 600 bed university medical center (adult inpatient). We currently have a PICC team and would be potentially expanding our service to a more comprehensive vascular access resource team. I would be so greatful to get any info from those of you working in a similar sized facility that has an existing team. Specifically:
how many beds?
how many FTEs?
hours of ocoverage? shifts?
scope of service?
estimated yearly budget?
Any of the above would be helpful. I have been pursuing this for over two years, knocking on every door, beating the drum. I am thrilled we have finally been officially heard. Now, it's a matter of coming up with the right model for our needs.
Thanks!
Yes, Virginia there is a Santa Claus and Yes, Yes, Yes, infusion teams still do exists. I am currently chairing an INS task force on this so look for more information to come shortly. We have, for the first time ever, written and validated a definition of infusion team. INS has a detailed workbook with loads of data collection tools and formulas for calculating the data you are seeking. These issues should be based on specific information for your facility, especially the scope of service. I would begin with the end - what are your current outcomes related to all types of catheters, both insertion and dwell. How about medication errors, pump issues, blood transfusion issues, parenterial nutrition, age related problems in pediatrics and geriatrics. What are the problems in each of these areas? Then go from there to figure out what should be included in your teams scope of practice. 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
depends on what you are trying to add as services. you need to figure what services you want to add. Hours you want to cover.
you need 1 RN FTE for every 800 PICC's
You need 1 RN FTE for every 1,000 PIV's
You need 1 RN FTE for every 800 central line dressing changes
If you are looking at coverage for 24/7 you will need a minimum of 7 FTE's as you have vacations and holidays to account for
I accounted for vacation and holidays
kathy Kokotis
Bard Access Systems
Sorry for my limited knowledge re: FTE's and budget (not my area) but we have a 300 bed hospital and 24/7 IV team. The team started out over 25 years ago as an infusion based team (gave all the IVP meds, TPN, blood products) to transitioning to what it is today.
Bedside PICC insertion with ultrasound
Peripheral IV starts (we've tried and tried to get the floor nurses to own this, some do some don't)
Peripheral IV starts using ultrasound guidance
Implanted port access/deaccess for patients outside of the oncology unit
Daily checks of all patients with central lines
Central line dressing changes (2 units do their own - we provide support)
Central line blood specimens (2 units do their own - we provide support)
Our staffing is M-F (3) 7a-7p, (2) 7p-11p, (1) 11p-7a; S-S (2) 7-3, (2) 3-11, (1) 11p-7a
Hope this helps
300 bed hospital
I can't say exactly how many FTE's we currently have, nor how many we utilize (as we get float and on-call staff working). However, I think it lands somewhere around 19 FTE's. This includes RN's, LPN's, and technicians
We have several divisions of our department that the same staff service. We have two infusion centers, one clinic, one hospital based. The clinic hours are M-F 0800-1630. The hospital center is 7 days a week, 365 days a year, 0800-2000. We have a home infusion segment, which is staff with an RN 0800-1600, 7 days a week, 365 days a year with someone on-call 24/7. We have a PICC team that doesn't have designated hours, it tends to go on a case by case basis. We provide apheresis, which is also a case by case thing. Then we have the acute section which provides services to the hospital and clinic departments. We start PIV's for most units (with the exception of ER, surgery, and a few other select procedural areas), draw blood from CVC's, do dressing changes and maintanence, TPA administration, troublshooting/complication management, and respond to code calls.
Budget I can't speak to.
It does work to our advantage to have a mixture of staff working. We have LPN's who assist in the infusion centers and on the acute side. Our technician's operate our dispatch desk during the day to manage calls from the units and assist on the floor. Otherwise, our unit is completely nurse managed, we do not work under the direct supervision of any single physician.
Congratulations on the approval of your full Vascular Access Team! You might be interested in the first ever National Data Base it was launched at AVA 3 weeks ago (www.piccregistry.com). By using this data base you can look at your hospital averages (number of PICCs placed, overall success rates, first attempt success rates, malposition rates and many more) compared to like hospitals in your area and in the near future have the ability to compare national averages. I will be using this data base as the evidence to get approval for a full Vascular Access team too! Good Luck