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 The basic bottom line will be outcome data. Do you have data to support the actual clinical outcomes produced by your activities and nursing interventions? I am not talking about productivity data of how many catheters you place or how many whatever procedures your team does. I am talking about phlebitis, infiltration, extravasation, CRBSI rates. That is the outcome of your work. Without such data, you may not have much hope, although it is hard for me to say that. There are published studies but I am totally swamped until I return from the INS convention so could not get a list to you before mid-May. Lynn

Although it might seem to be cruel to say so at this point, from what I have seen, when a hospital is thinking of cutting down their staff, the IV team is always the first few teams they start with. When they look at your job, the better you are at what you do, the easier they think they can handle it without you. I have experienced the same situation and the hospital let our PICC nurses go since we make the line placement look so easy and they believe they can have all the nurses trained to do so. Now they are hiring PICC nurses again realizing they are having a very bad patient outcome and a couple of the patients threatend to sue the hospital by being brutally poked for PICC or midline placement since the manager believe it is very normal to be poked many time for line placement because "everybody has a learning curve..." and it is unavoidable that somebody who is still learning poke some nerve or artery. It is acturally cheaper to have a special team to place lines and maintain them. But nobody would really investigate that when it comes to cut down budget.

Emily,

I couldn’t agree with you more! VA nurses can be victims of there own success. When someone watches me place a PICC, even our MDs say, “Wow, that’s easier than I thought.” They give no credit to that fact that I have placed almost 10,000 PICCs and I am a very skilled inserter with only 3% DVT rate and 0% PICC infection rate.

To save our teams, like Lynn said, you need data. But not just your own data from your own practice…data that compares you and your team and helps creates national quality measures, outcomes and benchmarks in vascular access. Data that shows how successful your team is performing compared to a national level – just like in other specialties. Collecting data locally on an Excel spreadsheet does not give your administration the information they need to make informed decisions. They need to know how your skill and your patient outcomes save them money compared to other hospitals. They need to be shown how getting the right device in at the right time will decrease LOS and will assist in getting the patient out and to alternative settings for treatment. Your data can show them that you are highly skilled and that you are able to potentially move into placing CVCs and art-lines. You are valuable to your hospital, but we have to prove it and be willing to move our practice and profession forward.

If we would just put our egos aside and begin to collect consistent data using consistent definitions and not be afraid to share this data (like for falls, restraints, MIs, pneumonias, just to mention a few), we would be a powerful group of vascular access nurses. Doctors use national data collection to impact their practice, so why don’t we do it in vascular access?  Administration is looking to create teams that can prove value and worth for their organization, not just teams that use the most expensive products and who cannot show quality. With comparative national data collection, you will secure your future as a vascular access clinician!