Are IV teams resurging? Has anyone recently started or expanded an IV team? I am particularly interested in organizations that have had to start budgets or add real/hard dollars to existing budgets. Are there lobbying groups out there in the political arenas advocating for patients' safety, comfort, and satisfaction with vascular access. IV outcomes need to get on the HCAHPS. It is amazing how quickly and dramatically a confluence of situations are arising: (a) extremely difficult venous access, (b) renal failure, (c) revisitism, (d) inadequate skill levels to place PIVs, (e) inadaquent IV assessment skills. What can we do and who wants to do it? does anyone know what Canada/Europe/Asia does regarding the usage of IV teams? Thank you and best regards.
I am now chairing a Task Force from INS on this very issue. The name has changed to infusion teams and we are working hard to get information to nurses about the business side of an infusion team. In May 2013 at the annual convention, we released a white paper, now available on the INS website and published in the JIN. We are in the final stages of writing a tool to educate nurses about writing a business case - a tool to justify the original investment and gain the decision to start or expand such a team. This is taking longer than we thought and we have not moved on to the political arena yet. 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
Many teams do not infuse anything; I think we need to look at marketing this specialty as Vascular Access Specialists. As a group we need to get a vascular access consults from here the specialist would determine the appropriate device for the future infusions.
When I put together the business plan to expand to CVC placement in the IJ, axillary/subclavian and femoral veins our physicians and leader ship were quite impressed that this proposal included a complete assessment.
We need to look beyond an “IV Teams” or “Infusion Teams” and focus on the entire package when developing business plans. So many organizations don’t want an “IV Team” I don’t agree—but they think anyone can start an IV. We need to sell them what our patients really need and includes someone who can assess the duration of infusions, the vasculature, co-morbidities, future vascular access needs, placing the appropriate device and rounding on all devices placed.
I hope we do see a resurgence in the need for a group of dedicated, highly skilled professionals caring for all of our patient vascular access needs.
This may be a case of a rose by any other name, etc, etc. From the very beginning of infusion teams in the 1940's they were not responsible for administering every dose of IV med, etc. I strongly believe that the scope of an infusion team is the broader, more comprehensive approach, based on the scope identified by the core content areas of the CRNI exam. Today, an infusion team is not one that only gives IV meds. But they are responsible for the education, QI, product evaluation, etc. along with the vascular access insertion component. From my perspective, the infusion nurse has the knowledge about the infusates to merge with the vascular access assessment and implementation. There is no doubt that a team could contain a subgroup with the responsibility and accountability for all CVAD insertion. But I also see that when the emphasis for such as team is placed exclusively on the insertion of the CVAD and there is no attention to the outcomes with peripheral catheters and the infusion aspects, there is a greater chance for problems and complications. Vascular access and infusion therapy is a marriage and they can not be separated. The same group of experts must have the responsibility for it all. 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
Hi all- I am writing this with a sad heart.
I have been at my institution for 15 years as part of an infusion/IV team that has provided 24/7 coverage for many years. Our 24/7 coverage was decreased to 20/7 last year and we have been experiencing a downsizing as positions were not replaced when nurses left. We had 20 nurses 4 years ago and had 8 nurses in our department now until 2 days ago we got hit with 3 layoffs and the deletion of the night shift providing 12/7 coverage now. I barely missed this cut, I am not convinced more hours and weekend coverage won't be going next.
We are being changed to a central device team. We have provided a valuable service for our patients and floor nurses for many years. Unfortunately, in these times of dwindling reimbursement for hospital services IV teams are becoming an easy target.
Juline DiSilvestro BSN, RN, CRNI, VA-BC, CPUI
Central Access Team Nurse
Inspira Medical Center- Woodbury,NJ
We are having the same cuts at our facility. It comes down to money. The hospital is not reimbursed for our picc placements therefore we were the first place cuts were made. I would love to assist Lynn with any INS led business plan to provide evidence that we are an essential service to reduce CLABSI, phlebitis, delay in treatment due to no vascular access, and ultimately patient satisfaction.
Molly Judge, RN, BSN, CRNI, VA-BC
Specialty Practice RN
IU Health Bloomington Hospital
Its hard to hear that it comes down to money. Unfortunately it is. In an effort to save teams we all need to look at the costs of ALL the products you are using to reduce supply cost. There are VERY expensive products on the market and there are products that are much less and are just as good. I was able to reduce overall costs of supplies by over half. Example: we were paying $18.00 for the probe cover now we are paying $6.00. There are too many others to list here.
Use a national level data collection tool to show how good you are or where you need improvement and improve. Collect data that impacts the specialty globally.
Third expand your practice beyond IVs and PICCs make yourself invaluable. Round on all CVADs in your organization, educate nurses on CVADs, declot , attend codes, place art-lines and CVCs. We can no longer just sit behind a closed door waiting for a PIV or a PICC order complaining about others on our teams or the nurses in the organization.