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The state of the art of central venous catheter care in the intensive care unit of a tertiary hospital; A quality initiative and call to action

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... For example, difficult IV access and central venous catheter insertion are generally associated with surgeons, anaesthetics and intensivist, yet this group does not routinely perform CVC dressing changes. In following up the impact of initial insertion decisions on postinsertion complications, a better approach could reduce complications (Carr et al. 2017). Modification of insertion practice to promote dressing integrity could lead to a reduction of catheter-related infection as evidenced in a large intensive care study (Timsit et al. 2012). ...
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Patients admitted to hospital are exposed to invasive procedures and will receive various interventions from different professional roles all with different levels of experience: some with limited experience and some with extensive experience. In simple terms, an orthopaedic surgeon fixes your broken bones, a cardiologist attends to your heart, a geriatrician focuses on elderly patient care, and a vascular surgeon focuses on vascular surgery. Yet, which vascular access device is inserted influences the clinical outcomes within each of these select specialties. Insertion procedures and care and maintenance are shared by a variety of healthcare professional disciplines, all with a variety of experience, guided by local policy frameworks. Because of this interdisciplinary sharing, responsibility becomes fragmented, and ownership of outcomes is lacking leading to increased patient safety risks. This chapter will firstly identify the various definitions that make up a vascular access specialist team (VAST) and secondly the variety of evidence supporting the concept and what empirical guidelines say about it. Finally, it explores the use of a vascular access specialist teams to promote unity in patient care and assurance that only well-trained clinicians who are qualified to select, insert and care for VADs can do so, promoting greater patient safety and positive patient outcomes.
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