부산대학교 도서관

Patients in oncology focused ICUs present unique challenges in IV access as they are both chronically and critically ill. The difficulty in gaining and maintaining IV access stems from poor vein assessment, choosing the incorrect gauge PIV, multiple attempts causing vein trauma and scarring, and needing urgent access. Our institution found an increase in Vascular Access Team (VAT) consultations to place Ultrasound-Guided PIVs (UGPIV). Thus, our team developed a nurse led self-sustaining UGPIV training program specific to the ICU oncology population. By utilizing a PICOT question and librarian collaboration, we found 15 articles that described UGPIV training programs from various healthcare settings. The literature focused on emergency rooms with a few from ICUs, but zero described challenges for ICU oncology patients. We used synthesis tables to subjectively assess the literature. Literature elements focused on class time and skills, initial competence, and competency maintenance. To integrate evidence, our team reviewed course content and skills with institution experts. We developed a badge buddy for nurse reference in UGPIV best practice. We provided best practice updates to our current UGPIV users. Nurses who have attended responded positively to class. Several asked for a second clinical day with the VAT to gain more confidence. This could be the result of placing UGPIVs in a highly specialized population with challenging vasculature. To date, 21 nurses are trained with 574 UGPIVS placed since April of 2021. Outcomes are ongoing and will be tracked using an EMR tracking tool quarterly. A robust UGPIV program for critically ill oncology patients has positive patient outcomes. Direct benefits for this patient population include shorter time to obtaining IV access, detailed vein assessment, knowledge of potential vein trauma, and fewer sticks. This program also has vital future implications to the critically ill oncology population. As these patients move through their treatment plans, the goal for them is to clinically improve and discharge home. However, many of these patients will require future IV access and they will still have viable veins thanks to the mindfulness of UGPIVs placed in the past by our UGPIV trained oncology ICU nurses. [ABSTRACT FROM AUTHOR]