Kerry Taliaferro CNC Intravenous Access Team Canberra Hospital ACT AVAS ASM 2017 DEVELOPMENT OF AN INTRAVENOUS ACCESS TEAM CREDENTIALING PACKAGE
KerryTaliaferroCNC
IntravenousAccessTeam
CanberraHospitalACT
AVASASM2017
DEVELOPMENT OF AN INTRAVENOUS ACCESS TEAM CREDENTIALING PACKAGE
Financial Disclosures
1.DisclosureofRelevantFinancialRelationships
Ihavenofinancialrelationshipstodisclose
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Canberra Hospital & Health Services
Acutecareteachinghospital
600inpatientbeds
ServicesACT&SouthernNSW
Providesspecialistandacutecaretomorethan500,000people
IVATestablished2014
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International Programs
PICCACADEMYNETWORK(PAN)• TraintheTrainer• 40• Expense• RecognitioninAustralia
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WoCOVA evidence based consensus
• StandardminimalrequirementsfortrainingonCVAD’s
• 16recommendationsaskeytoensuringsafeandcompetentpractice
• Standardiseeducation
• Simulationpractice
• Supervisedinsertions
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The Basics
• A&P• Ultrasound• CVADknowledge• Infectioncontrol&SurgicalANTT• Deviceselection• Insertionmethods• Troubleshooting• CareandMaintenance• Proficiencyandcredentialing
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Adult learning methods
• Experientiallearning• Integrationofknowledge,activityandreflection
• Experientialeducation• Takeintoaccountlearnersknowledgebase/experience
• Situatedlearning• Active/guidedparticipationthroughapprenticeship• Communityofpractice• Student– Mentor
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Offer Variety
• Facetoface
• Elearning
• External
• Internal
• Simulation
• Handsonsupervised
• Formalobjectivecredentialing
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The Learner
• Gainknowledge,skills,competency
• Establishedrequiredstandards
• Achieveidentifiedoutcomes
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CredentialingCriteriaforPICCInsertionsforIVATmembers
PreRequisites
CompetencyAchievedin
SuccessfulapplicationtoIVATRN2role
Venepuncture andbloodcollection
Intravenouscannulation
TrainingduringIVATRN2roletoachievePICCinsertioncompetency
AttendonedayUltrasoundguidedPICCinsertionworkshop
Completethesee-learningprograms
Consent
Aseptictechnique
CVADCareandmaintenance
PatientidentificationandProcedurematching
Scrubbinggowningandgloving
OneononelectureonCVAD’sandUltrasoundguidedaccesswithIVATCNCandStaffspecialistICU
SupervisedPICCinsertionswithIVATCNC– until
PassIVATCVADinsertionandcareexam
FormalClinicalCompetencyofprocessfromreferraltocompletedinsertionandfollowup
OrientationtotheIVATRN2role
VascularAccessDeviceSelection,InsertionandManagementOnlineCourse(CourseCost:$50.00- optional)
UltrasoundforPeripheralAccessTrainingCourse
Sherlock3CG*TipConfirmationSystem(TCS)TrainingCourseandcompetency
Completeelearning programsathttps://www.bardaccess.com/clinical_training/login.php
MaintainInsertionSkillsReassessmentEvery3years
DIVISIONOFMEDICINEExecutiveDirectorofMedicine
DirectorofNursing
AmbulatoryServicesAssistantDirectorofNursing
INTRAVENOUSACCESSTEAM
IVATCNC
NHSQSTANDARD3.9.1:INVASIVEDEVICES STANDARD3COMMITTEE
Scrubbinggowningandgloving/SurgicalANTT/ECGTCSPracticalassessment Obtain
Ultrasoundguidedaccesstrainingandcompetency
TraininginECGTCS
IVATRN2
Training for IVAT RN 2 role
• OrientationtoIVATRN2role• AttendexternalonedayUltrasoundguidedPICCinsertionworkshop
• OneononelecturesonCVAD’sandUltrasoundwithCNCandStaffspecialistICU
• S,G&G/SurgicalAseptictechniquetraining
• SupervisedPICCinsertionswithCNC
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Assessments
• S,G&G/Aseptictechnique>Practicalassessment• FormalClinicalCompetencyofprocessfromreferraltocompletedinsertionandfollowup• PassIVATCVADinsertionandcareexam
• MaintainInsertionSkills
• Reassessmentannually
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Competency based assessment
Fourdomains• ProfessionalPractice
• CriticalThinkingandAnalysis
• ProvisionandCoordinationofCare
• CollaborativeandTherapeuticPractice
ArandaS,YatesP.Competencyassessmenttoolformanagementofcentralvenousaccessdevices(CVADs).Canberra:TheNationalCancerNursingEducationProject(EdCaN),CancerAustralia;2009.
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PERFORMANCE LEVEL
COMPETENTEstablishedcompetenceasaspecialistwithintheirclinicalfieldofpracticeCOMPETENTBeginningcompetenceasaspecialistwithintheirclinicalfieldofpracticeNOTYETCOMPETENT
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Written exam topics
• Anatomy&Physiology• Patientassessment&deviceselection• Insertion• Documentation• Complications• Management• Scenarios
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Ultrasound Skills
33
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
HoldingtheProbeSteady
Identifyingvessels/nerves/structures
AccessingveinsforPICCinsertion
AccessingveinsforPIVC
(cannula) insertion
Identifyingtheneedletip
RankedEasiest(1)toHardest(5)
AverageRank
LowestRanked
HighestRanked
Did you undertake independent research for the exam?
Yes=3No=1• Hospitallibrary• Generalanatomyfromtestbooks• Hospitalpolicy• Intravenousaccessjournals• BARDonlinearticles
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Knowledge level
37
0
10
20
30
40
50
60
70
80
90
100
Lowestranking Highestranking Averageranking
HowwouldyourateyourknowledgeofCVAD'sonascaleof1to100(100=expert)
BeforeTraining Aftertraining
Validation
• NHSQSAccreditation2105• Standard3HAICommittee• SDU- Capabiliti• EducationActivityReport• RegisteredVET
• ValidationbyexternalPICCCNC
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