Vessel Health and Preservation: The Right Approach for Vascular Access

Nancy Moureau, RN, PhD, BSN, CRNI, CPUI, VA-BC is an internationally recognized speaker and expert in the field of vascular access, infusion therapy and specifically peripherally inserted central catheters. A nurse for more than 35 years, Nancy continues her clinical work as staff member on the PICC/IV team at Greenville Memorial Hospital SC, USA. As the owner and CEO of PICC Excellence, Nancy creates online educational programs and works with companies to provide education to clinicians. She is constantly involved with research and literature analysis, now working in conjunction with Griffith University, Brisbane, Australia where she earned her PhD in 2017 and the AVATAR group Alliance for Vascular Access Teaching and Research as an adjunct associate professor. Nancy takes on many projects and most recently chaired the International Consensus Forum for the World Congress of Vascular Access (WoCoVA) to establish Standard Minimal Education Requirements for Central Venous Access Devices. She has established the only registered PICC Certification process, Certified PICC Ultrasound Inserter, where those who meet and maintain qualifications gain the credentials CPUI. The author of more than 50 publications, recipient of the Herbst Award for lifetime achievement and key opinion leader on vascular access.

This Open access book offers updated and revised information on vessel health and preservation (VHP), a model concept first published in poster form in 2008 and in JVA in 2012, which has received a great deal of attention, especially in the US, UK and Australia. 
The book presents a model and a new way of thinking applied to vascular access and administration of intravenous treatment, and shows how establishing and maintaining a route of access to the bloodstream is essential for patients in acute care today. Until now, little thought has been given to an intentional process to guide selection, insertion and management of vascular access devices (VADs) and by default actions are based on crisis management when a quickly selected VAD fails. The book details how VHP establishes a framework or pathway model for each step of the patient experience, intentionally guiding, improving and eliminating risk when possible. The evidence points to the fact that reducing fragmentation, establishing a pathway, and teaching the process to all stakeholders reduces complications with intravenous therapy, improves efficiency and diminishes cost. As such this book appeals to bedside nurses, physicians and other health professionals.

Presents the first comprehensive intentional process for vascular access selection, insertion, management and evaluation

Preface (Nancy Trick)About the concept of VHP, beginnings, process and ideal Section 1. Right Assessment and Right Vein ( Tim Jackson)Chapter 1. Catheter and vein selection with avoidance of joints and danger zonesChapter 2. Ultrasonic assessment and placement of right device Section 2. Right Training (Evan Alexandrou)Chapter 3. Training process, competencies, preparation for PIV, PICC, CVC insertions Section 3. Right Insertion (Steve Hill lead and possibly coordination with others)Chapter 4. Catheter size, type, number of lumen for patient and treatmentChapter 5. Placement with no more than 2 attemptsChapter 6. Infection Prevention principles with Kits for insertion and compliance with sterile procedure (bundles, checklist, CHG, etc)Chapter 7. Tip positioningChapter 8. Securement Chapter 11. Right Device assessment (type, size, no. of lumens)Chapter 12. Right Technology assessmentChapter 13.  Why is VHP important in paediatrics?Chapter 14. Troubleshooting in paediatrics.
Section 5. Right Supplies and Technology (Rob Dawson)Chapter 15. UltrasoundChapter 16. Insertion kits for USGPIV, PICC, Midline, CVCChapter 17. Antimicrobial dressingsChapter 18. Needleless connector issues Section 6. Right Care and Assessment (Carol Hallam and Val Weston )Chapter 19. Daily or twice daily assessment for catheter function, dressing adherence and necessity of deviceChapter 20. Hub disinfection issues and compliance measuresChapter 21. Flushing with proper techniques Section 7. Right EvaluationChapter 22. How to evaluate a VHP program initiative (Lisa Gorski)Chapter 23. Staff education and satisfaction (Lisa Gorski)Chapter 24. Patient satisfactionChapter 25. Pathway effectiveness and outcome measures